Frozen shoulder also known as adhesive capsulitis, is a condition characterized by stiffness pain and limited motion in the shoulder jointthat lasts for several weeks at a time. It typically progresses through stages, including.
- Freezing stage- gradual onset of pain and stiffness
- Frozen stage-severe stiffness and limited motion.
- Thawing stage-gradual improvement in range of motion.
Apabahukam
-In Ayurveda the concept of APABAHUKA can be correlated with Frozen shoulder to some extent. It is explained as a Vataroga with difficulty in movement of arms due to the distortion of nerves in the base of shoulder joint.Amsamoolasthitho vayussiraa samkochya ththragaa: Baahupraspandithaharam janayatyapabaahukam.(A.H Su) What causes Frozen Shoulder
The causes or precipitating factors of Frozen shoulder can be multifaceted and may involve a combination of factors:
Idiopathic: In many cases the exact cause of Frozen shoulder is not clear, it is believed to result from inflammation, scarring, and the thickening of the capsule surrounding the shoulder joint. Inflammation: Inflammation of the shoulder joint or the surrounding tissue can be caused by various factors, including injury, trauma or an underlying medical condition. Medical conditions: Certain medical conditions like Diabetes Melitus which is known to affect the connective tissues, and auto immune diseases like Rheumatoid Arthritis. Immobilization: Prolonged immobilization or lack of movement of the shoulder joint can result in the thickening of the shoulder joint capsule and the formation of adhesions. Frozen shoulder also occurs sometimes when someone is wearing a sling or a cast. Nowadays, one of the commonest causes for frozen shoulder is “Text Neck’’ which involves extensive duration of hanging the neck forward while on the mobile or other electronic devices.
Inflammation: Inflammation of the shoulder joint or the surrounding tissue can be caused by various factors, including injury, trauma or an underlying medical condition. Medical conditions: Certain medical conditions like Diabetes Melitus which is known to affect the connective tissues, and auto immune diseases like Rheumatoid Arthritis. Immobilization: Prolonged immobilization or lack of movement of the shoulder joint can result in the thickening of the shoulder joint capsule and the formation of adhesions. Frozen shoulder also occurs sometimes when someone is wearing a sling or a cast. Nowadays, one of the commonest causes for frozen shoulder is “Text Neck’’ which involves extensive duration of hanging the neck forward while on the mobile or other electronic devices.
Medical conditions: Certain medical conditions like Diabetes Melitus which is known to affect the connective tissues, and auto immune diseases like Rheumatoid Arthritis. Immobilization: Prolonged immobilization or lack of movement of the shoulder joint can result in the thickening of the shoulder joint capsule and the formation of adhesions. Frozen shoulder also occurs sometimes when someone is wearing a sling or a cast. Nowadays, one of the commonest causes for frozen shoulder is “Text Neck’’ which involves extensive duration of hanging the neck forward while on the mobile or other electronic devices.
Immobilization: Prolonged immobilization or lack of movement of the shoulder joint can result in the thickening of the shoulder joint capsule and the formation of adhesions. Frozen shoulder also occurs sometimes when someone is wearing a sling or a cast. Nowadays, one of the commonest causes for frozen shoulder is “Text Neck’’ which involves extensive duration of hanging the neck forward while on the mobile or other electronic devices.
Ageing: Frozen shoulder tends to be more common in individuals over the age of 40, and the risk increases with age. Precipitating factors that can exacerbate frozen shoulder symptoms or trigger its onset may include: • Overuse or Repetitive movements-lead to increased pain and stiffness. • Poor posture-put added stress on the shoulder joint and worsen the symptoms. • Stress or anxiety-lead to muscle tension and increased pain. • Lack of physical activity-can contribute to stiffness and reduced range of motion.
AYURVEDIC PERSPECTIVE
According to Ayurveda the building blocks of any living being is VATA, PITTA & KAPHA. This comprises both structural and physiological factors. These are called the “Thridoshas” and there is an equilibrium of these three doshas to stay in a healthy condition, though the equilibrium is different for different individuals. Any change in the equilibrium causes a discomfort and can form a disease. Any change that causes the imbalance becomes the Nidaana or reason for the disease. Apabahuka is a disease condition where pain and stiffness are the main symptoms. In Ayurveda these symptoms appear as an imbalance caused to the Vata dosha in our body. The disease manifests on the part which is more susceptible to the change. In Apabahuka, the weak point is the Amsa sandhi or shoulder joint. Excessive stress: High levels of stress, anxiety, and emotional turmoil can disturb the balance of Vata in our body. Inconsistent routine: Irregular sleep patterns, meal times etc can disrupt the natural balance of Vata. Inadequate rest: Alack proper rest, including insufficient sleep can increase Vata dosha. Excessive physical activity: Overexertion, especially when the body is not adequately nourished or rested can aggravate Vatadosha. Cold and dry climate: Living in or exposure to cold and dry climate can increase Vatadosha in the body. Unhealthy diet: Consuming foods that are dry, cold and rough in texture as well s a diet that lacks proper nourishment, can imbalance Vata. Dehydration: Insufficient water intake and dehydration can aggravate Vata due to its airy qualities. Age: Vata naturally increases with age, so the elderly are more susceptible to Vata imbalances. Emotional upheaval: Experiencing, grief, fear, or loss can increase Vatadosha. Inadequate self-care: Neglecting self-care practices such as daily oil massage(abhyangam), meditation, and mindfulness can lead to Vata imbalances. It’s important to note that Ayurveda emphasizes the uniqueness of each individual’s constitution (prakruthi), and imblances (vikruthi). There-fore the factors that lead to Vata vitiation can vary from person to person.
Management of Frozen Shoulder
Treatment options may include physical therapy, pain management, and in some cases corticosteroid injections or surgery. It's important to consult a healthcare professional for a proper diagnosis and personalized treatment plan if you suspect you have frozen shoulder, as early interventions can help manage the condition more effectively. Health care professionals use various investigations and tests to assess the condition and rule out other potential causes of shoulder pain and stiffness. Ayurvedic way of managing Frozen shoulder Apabahau hitam nasyam snehaschoutharabhatika. Ayurvedic treatment for apabahukam typically involves a combination of therapies, such as panchakarma treatments, herbal remedies, massage, and lifestyle modification to balance vatadosha and alleviate symptoms. Panchakarma is a traditional Ayurvedic detoxification and rejuvenation therapy that aims the balance or equilibrium of one’s body building constituents called doshas (Vata, Pitta and Kapha) and thus to promote overall well-being. • Abhyanga: application of warm medicated oils can help reduce the stiffness and pain in the shoulder and improve blood circulation. • Svedana: Herbal steam therapy- can help relieve muscle tension and increase flexibility in the affected area. • Dhara: Local or whole body dhara with warm medicated oils can give the effect of both abhyanga and sveda together. • Herbal remedies: Ayurvedic herbs and formulations may be prescribed to manage pain , inflammation and stiffness. • Yoga and Pranayama: Certain yoga postures and breathing exercises can help improve shoulder flexibility and reduce pain. These should be practiced under the guidance of a qualified yoga instructor. • Nasya: Nasya involves the administration of medicated oils and herbal preparations through the nostrils. It can help balance vata and reduce pain and inflammation. This can be done as a symptomatic management and as a curative method with difference in dosage of medicine application. Rogasthu doshavaishamyam- a disease is an imbalance in the constituents of the body. In Apabahukam or Frozen shoulder, the constituent which is getting affected is Vatadosha. So vatahara medicines are being applied internally and externally. When the disease condition is acute with swelling and severe pain, we need to manage those symptoms first by applying sophahara (anti-inflammatory) lepas (ointments and bandages) and internal medications. When the swelling subsides, application of oils, local massage, and steam application will help to reduce the stiffness and improve the mobility. At this stage Brumhana Nasya with medicated oils in small dosage (Pratimarsha)can be given as symptomatic management. Intake of vatahara formulations during the whole course of treatment is recommended. Vatahara ghee preparations in small dosage can be taken post lunch. Practicing Yogasanas will help to gain complete mobility and muscle strength. Always seek professional guidance before undergoing any Ayurvedic treatment.
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