Re: Article - Adhesive Capsulitis (frozen shoulder)

January 10, 2004

> This is an old message. I am so far behind.

>

> My daughter (HEDS) has a permanent numb area on her back that goes

from her neck to under her scapula and about 7 inches wide. Does

this sound like it would be seen with Adhesive Capsulitis?

>

> It happened when she rolled over in bed incorrectly in August and

it has been numb since. They are just now advising pt; and have not

yet done a mri or a sonar; only a xray which showed nothing. I know

that those things are needed but we are on Medicaid and as difficult

as it is to get someone to treat us... It just got a whole lot

harder.

>

> Any thoughts on how she can deal with this on her own? I cant

massage it as my thumbs dislocate.

>

Can you be a bit more specific on the numb area? You say that it

goes from her neck to under her scapula. Does it go from the base

of the neck where the neck meets the shoulder or more from where the

neck meets the base of the skull? You also say the numb area is

about seven inches wide. Is it dumb from along the edge of the

spine out toward the shoulder or is it more totally under the

scapula? I am assuming from your post that it is just on one side,

not both?

The reason I am asking is that I can think of two or three specific

muscles that might be involved depending on the specifics of the

numb area.

Just from being numb under the scapula raises the possibilty that

Adhesive Capsulitis might be involved because that is where the

subscapularis muscle is, and the subscap is one of the four rotator

cuff muscles. AC, however, is not the first thing I would think of

from what you describe since AC is generally more specific to the

shoulder joint itself. I am going to quote the section on this

from " Pathology A to Z " by Dr. Kalyani Premkumar.

Let me know on the questions and I might be able to come up with

some ideas for you, both in terms of what it might be and how to

work on it.

As for your not being able to massage it because your thumbs

dislocate - there is a very easy fix for that. Just don't use your

thumbs. Make a fist and use the flat part of the fist, or your

knuckles or the edge of your hand, your elbow, your forearm, etc.

" Adhesive Capsulitis (Frozen Shoulder, Scapulocostal syndrome;

Calific tendinitis of the rotator cuff; Subacromial fibrosis;

Pericapsulitis; Acromioclavicular arthritis)

Cause:

The cause is not known in most situations. It may be caused by

misalignment of the scapula with the humerus as in individuals with

kyphosis. It may also be due to the spread of inflammation from

lesions of the rotator cuff coupled with fibrosis of the capsule.

Rarely, degenerative shoulder joint disease, rheumatoid arthritis,

and prolonged immobilzation can cause this condition.

Signs and Symptoms:

There is a slow restriction of movement of the arm to the point of

affecting daily activities such as combing hair. The patient finds

it difficult to abduct and flex the arm and has difficulty moving

the arm to the back. There is limitation of external rotation,

abduction, flexion and internal rotation of shoulder. It may be

associated with gradual onset of a dull ache. Pain is referred to

the C5, C6 area. In acute frozen shoulder, the pain may radiate to

below the elbow. In chronic conditions, nocturnal pain is absent

and pain is felt only on stretching the capsule.

January 10, 2004

Mike,

Thank you for the prompt and kind reply(s)

Concerning the post on popping in the spine; since there aren't really

joints there it cant be gas bubbles. I am thinking some sort of pathology.

The last time I saw a pt I asked her if they were going to do a mri on it;

she said 'not until your legs suddenly buckle'.

As for my daughter...

> Can you be a bit more specific on the numb area? You say that it

> goes from her neck to under her scapula. Does it go from the base

> of the neck where the neck meets the shoulder or more from where the

> neck meets the base of the skull?

Where the neck meets the shoulder to the bottom of the shoulder blade.

> You also say the numb area is

> about seven inches wide. Is it dumb from along the edge of the

> spine out toward the shoulder or is it more totally under the

> scapula?

From the spine to beneath her arm

> I am assuming from your post that it is just on one side,

> not both?

Right side

> The reason I am asking is that I can think of two or three specific

> muscles that might be involved depending on the specifics of the

> numb area.

>

> Just from being numb under the scapula raises the possibilty that

> Adhesive Capsulitis might be involved because that is where the

> subscapularis muscle is, and the subscap is one of the four rotator

> cuff muscles. AC, however, is not the first thing I would think of

> from what you describe since AC is generally more specific to the

> shoulder joint itself. I am going to quote the section on this

> from " Pathology A to Z " by Dr. Kalyani Premkumar.

>

> Let me know on the questions and I might be able to come up with

> some ideas for you, both in terms of what it might be and how to

> work on it.

Thanks; I appreciate that.

Just an aside: They gave her a prescription for pt for 180 days; but told

her they knew of no one that would take it. They told her to call the

Medicaid office and find out who takes Medicaid. There is no one in the

Medicaid office any longer. We received this notice through the mail about

six months ago. I could try to go through Legal Aid to get a reply. She

goes back to college next weekend. It is six hours north of here; she will

have to take the prescription there but I doubt that anyone up there takes

Medical either; since it is done through the counties. And with the changes

in this state it sounds like there will be even less.

The reason I mention that is that I doubt she will receive a pt consult at

all; and she will be stuck figuring this out and dealing with it on her own

in a college dormitory with no help from others. So whatever you can

suggest would be great. At the very least it won't hurt her and will help

her feel in control of it.

> As for your not being able to massage it because your thumbs

> dislocate - there is a very easy fix for that. Just don't use your

> thumbs. Make a fist and use the flat part of the fist, or your

> knuckles or the edge of your hand, your elbow, your forearm, etc.

I will give it a try tonight; thanks for the suggestion.

January 10, 2004