Thawing a Frozen Shoulder: An Alternative Treatment Option
Written By: Sahannah Seemungal, Rhea Mittal, and Laila Ibrahim
Frozen shoulder, medically known as adhesive capsulitis, is a painful and often debilitating condition that can make everyday tasks such as showering, dressing, cooking, and sleeping challenging. This condition occurs when the connective tissue surrounding the shoulder joint becomes thick and inflamed, significantly restricting mobility in all directions. The term “frozen” is used because it describes how increased pain leads to the shoulder progressively stiffening as if it is stuck in a “frozen” position, therefore restricting it from moving normally. While the exact causes are unknown, certain individuals are more susceptible to developing the condition. This includes women from ages 40-60 who have recently undergone shoulder surgery or trauma, or individuals with underlying health conditions such as diabetes or stroke.
Frozen shoulder progresses in three phases: the “freezing” phase, the “frozen” phase, and the “thawing” phase. The “freezing” phase manifests as severe pain in the shoulder, typically experienced at night, resulting in a limited range of motion. This phase can last 2 to 9 months. During the “frozen” phase, the pain may reduce but the immobility persists due to the stiffness in the shoulder joint, which lasts from 4 to 12 months. Lastly, the resolution or “thawing” phase can last 12 to 36 months and is characterized by decreased pain, the ability to move the shoulder, and strength gradually regaining full or near recovery.
Some of the traditional treatments for frozen shoulder include physical therapy for stretching and strengthening the surrounding tissue to relieve tension, nonsteroidal anti-inflammatory medication, or cortisone injections, a steroid medication injected directly into the shoulder joint to reduce inflammation and provide pain relief. Surgery is also a common intervention performed in managing chronic pain, but is limited specifically to managing peripheral nerve pain, especially in the shoulder. Unfortunately, patients with frozen shoulder don’t always experience complete relief from the pain even after undergoing these treatments.
Neurological stimulation for pain management has been utilized for years. Advancements in technology have led to numerous studies demonstrating the effectiveness of peripheral neurostimulation, a medical technique that uses electrical pulses to treat chronic pain. Peripheral nerve stimulator systems serve as an innovative approach to treating chronic pain, including frozen shoulder for patients seeking relief from their intractable pain. Curonix offers the FDA-cleared Freedom PNS System to help patients take control of their pain and improve their quality of life. This minimally invasive system is designed to transmit electrical stimulation to a specific nerve near the shoulder, preventing the pain signals from reaching the brain. More importantly, patients experiencing pain in the shoulder, even without a formal diagnosis of frozen shoulder, as well as patients with refractory pain post shoulder surgery can benefit from the Curonix Freedom PNS System as a treatment option.
The process begins with a consultation with the patient’s healthcare team to review their medical history, symptoms, and goals to tailor the therapy to their specific needs. Their providers will then conduct a thorough physical and psychological assessment to understand their pain and its impact on daily living to determine their candidacy for Freedom PNS. If the patient is a suitable candidate, they will undergo a trial period for up to 30 days to assess the therapy’s effectiveness for their physical and psychological well-being. During this period, the patient will receive an implanted stimulator to block the pain signals to the brain, an assembly and antenna to deliver signals to the implanter through the skin, and a torso wearable to hold the transmitter assembly in place comfortably. If the trial is successful, and the patient and their providers agree to proceed, the next step will be coordinating the permanent implantation of the device.
Whether officially diagnosed with a frozen shoulder, experiencing refractory pain after shoulder surgery, or dealing with chronic shoulder pain in general, it can significantly impact daily life, making it impossible to perform even the simplest tasks. While conventional treatments may provide some relief, such as pain relievers and shoulder exercises, patients may continue to experience pain and stiffness in the shoulder joint. Fortunately, the Curonix Freedom PNS System offers another treatment option. Healthcare providers can coordinate with the patient to determine if this therapy is a good fit, so that they can restore motion, function, and bring back their quality of life.
References:
Cleveland Clinic. (n.d.). Frozen shoulder (adhesive capsulitis). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/frozen-shoulder-adhesive-capsulitis
Curonix. (n.d.). Shoulder pain. Curonix. https://curonix.com/patients/shoulder-pain/
Lyne, S.A., Goldblatt, F.M. & Shanahan, E.M. Living with a frozen shoulder – a phenomenological inquiry. BMC Musculoskelet Disord 23, 318 (2022). https://doi.org/10.1186/s12891-022-05251-7
Manchikanti, L., Sanapati, M. R., Soin, A., Kaye, A. D., Kaye, A. M., Solanki, D. R., Chen, G. H., Nampiaparampil, D., Knezevic, N. N., Christo, P., Bautista, A., Karri, J., Shah, S., Helm Ii, S., Navani, A., Wargo, B. W., Gharibo, C. G., Rosenblum, D., Luthra, K., Patel, K. G., … Hirsch, J. A. (2024). Comprehensive Evidence-Based Guidelines for Implantable Peripheral Nerve Stimulation (PNS) in the Management of Chronic Pain: From the American Society Of Interventional Pain Physicians (ASIPP). Pain physician, 27(S9), S115–S191. https://pubmed.ncbi.nlm.nih.gov/39565237/
