الكتف المتجمد

Elevated blood sugar levels promote collagen cross-linking within joint tissues, making the shoulder capsule thicker, tighter, and more prone to severe stiffness. Diabetic patients face a significantly higher risk of developing frozen shoulder, and it frequently affects both shoulders consecutively or simultaneously.

Intra-articular cortisone injections provide rapid, substantial relief during the early freezing phase by arresting inflammatory capsule thickening. Hydrodilatation—injecting sterile saline and anesthetic to gently expand the tight capsule—can immediately improve joint capacity and mobility when combined with targeted physical therapy.

Frozen shoulder naturally progresses through three phases: the Freezing stage (severe pain and worsening stiffness, 2–9 months), the Frozen stage (reduced pain but severe motion loss, 4–12 months), and the Thawing stage (gradual recovery of movement, 6–24 months). Without structured treatment, full resolution can take 1 to 3 years.

Arthroscopic capsular release is considered when persistent joint stiffness and functional restriction fail to improve after 6 to 9 months of conservative therapy and injections. The surgeon precisely divides the contracted capsule tissue to restore complete range of motion, followed by immediate post-operative physical therapy.

Yes. Overly aggressive or painful stretching during the early inflammatory (freezing) phase exacerbates capsule inflammation and worsens pain. Rehabilitation must be carefully staged: gentle, passive range-of-motion exercises are used initially, progressing to active stretching and strengthening only after acute inflammation subsides.