Imagine the frustration of reaching for your morning coffee or trying to fasten your seatbelt or throwing a ball only to be halted by a sharp pain and an unyielding stiffness in your shoulder. This isn't just a scenario for the aging population but increasingly a reality for many, courtesy of our modern lifestyles.
Normally the shoulder has a wide range of motions making it the most mobile joint in the body. But because of its flexibility it's unstable and one of the most frequently injured joints in the body.
Medically called GLENOHUMERAL JOINT or AMSA SANDHI in Ayurveda, the shoulder joint connects the upper limb and the axial skeleton. The health of this joint is essential for various daily activities like lifting, pushing, pulling and rotating the arm.
Sometimes the shoulder joint becomes stiff, inextensible and painful in a mysterious way. This is how the most common musculoskeletal disorder FROZEN SHOULDER or AMSA SANDHI GRAHA presents itself. It's a common ailment that can significantly impact one's quality of life making even simple tasks challenging.
WHAT IS AMSA SANDHI GRAHA
In Ayurveda, "Amsa" means shoulder, "Sandhi" refers to joint, and "Graha" denotes stiffness or seizure. Put together, Amsa Sandhi Graha represents a condition characterized by pain, stiffness, and restricted movement in the shoulder joint. This ancient concept beautifully encapsulates what modern medicine identifies as Frozen Shoulder or Adhesive Capsulitis.
WHY THE TERM FROZEN SHOULDER
The term “frozen shoulder” aptly describes the loss of movement in the shoulder, which feels as if it’s “frozen” in place due to the pain and stiffness most probably at night. The probable cause may be because of the thickening of connective tissue or capsule which results from a combination of inflammation, scar tissue formation (adhesions) and reduced lubrication within the shoulder joint.
THE UNDERLYING CAUSES: A DANCE OF DOSHAS
Ayurveda attributes Amsa Sandhi Graha to an imbalance in all the three doshas.
Vata, the principle of movement, when aggravated, leads to sharp shooting intermittent pain particularly in the night, dryness or roughness around the shoulder joint, cracking or popping sounds from the shoulder during movement, stiffness and restricted movement of the shoulder joint, noticeable decrease in muscle mass and strength in the shoulder and surrounding areas, abnormal sensations in the shoulder and arm, potentially affecting the entire limb.
Pitta, the principle of metabolism, when aggravated, leads to inflammation, redness and burning sensation around the shoulder joint and severe stabbing pain.
Kapha, the principle of stability and strength, when aggravated, leads to swelling, heaviness, dull aching pain, stiffness and sometimes a feeling of coldness and numbness in the shoulder joints.
These imbalances can be triggered by various factors, such as:
Lifestyle Factors: Poor posture, lack of exercise, or repetitive overuse of the shoulder joint.
Trauma: Physical injuries or overexertion can initiate the cascade of Vata imbalance.
Aging: Natural degeneration of tissues and joints with age
Accumulation of Ama: Toxins (ama) in the body can accumulate in the joints, leading to inflammation and pain.
Other indirect causes include BRACHIAL PLEXUS INJURY, CERVICAL RADICULOPATHY, DIABETIC NEUROPATHY, ROTATOR CUFF DISORDERS, SUBACROMIAL BURSITIS, THORACIC OUTLET SYNDROME, SHOULDER OSTEOARTHIRITS, CARDIOVASCULAR DISORDERS, GALL BLADDER DISORDERS, INFLAMMATORY CONDITIONS LIKE POLYMYALGIA RHEUMATICA, RHEUMATOID ARTHRITIS
CLINICAL PRESENTATIONS
Amsa Sandhi Graha manifests in ways that are strikingly similar to Frozen Shoulder:
Pain: Persistent, often severe pain in the shoulder that can radiate down the arm.
Stiffness: Significant reduction in the range of motion, making everyday activities challenging.
Swelling: Possible swelling around the shoulder joint.
Weakness: Muscle weakness due to restricted movement and disuse.
DISEASE PROGRESSION
It often progresses through stages:
freezing (pain and limited range of motion) which lasts for 6-9months
frozen (pain reduces but the shoulder becomes stiff) which lasts for 4-12months
thawing (gradual return of movement) which lasts for 5months - 2 years.
RISK FACTORS
Age and sex : occurs in 2-5% of population with most patients being females and over the age of 55.
Prolonged immobilization of the shoulder, such as after surgery or an arm fracture
Individuals with systemic disorders like diabetes, thyroid issues, TB, Cardiovascular disorders are more susceptible to developing AMSA SANDHI GRAHA.
MANAGEMENT
Understanding the condition is the first step towards effective management and recovery.
Conventional treatments include physical therapy, medication, and sometimes surgery. However, these can be invasive and may not always provide long-term relief.
Ayurveda offers a holistic approach to managing Amsa Sandhi Graha, focusing on balancing the doshas and restoring harmony within the body.
1.PANCHAKARMA THERAPY
By embracing the principles of Ayurveda, our experienced therapists at SAKALYA AYURVEDA employ a range of Ayurvedic Panchakarma therapies depending on the individual's body constitution, underlying cause for the condition and specific imbalances that needs to be addressed.
These Panchakarma therapies , a cornerstone of Ayurvedic treatment , play a crucial role in the following ways :
lubricates and softens the tissues
reduces stiffness and pain
relaxes muscles
improves circulation and range of motion
arrests further progression
rejuvenates the degenerated connective tissue
improves digestion and metabolism
supports our body’s natural healing processes.
2. HERBAL REMEDIES
Consuming appropriate internal medicines which are anti inflammatory, analgesic and nourishing under the guidance of our experienced Ayurvedic physician are also often necessary to complement external therapies.
3. LIFESTYLE MODIFICATIONS
Diet: following a diet rich in warm, cooked foods can reduce the risk of pain and stiffness
Exercise: Engage in gentle shoulder exercises and stretches like Garudasana, Dhanurasana, Paschima Namaskaraasana and many more under the guidance of an expert to maintain mobility.
Stress Management: Practice Yoga, Meditation and other stress reducing activities.
Regular sleep: Maintaining a regular sleep schedule supports overall health.
RECOVERY TIME
Recovery time can vary depending on the stage of the disease and the individual's response to treatment.
Early Stages: In the initial stages, consistent application of Ayurvedic therapies and internal medicines may lead to noticeable relief within a few weeks (around 4-6 weeks).
Intermediate Stages: As the condition progresses, it may take several months (around 3 to 6 months) of regular treatment to experience significant improvement in pain reduction and increased shoulder mobility.
Advanced Stages: For chronic or severe cases, the healing process may extend beyond 6 months. Patience and persistence are crucial during this phase.
PRECAUTIONS
Avoid lifting of heavy objects and other movements that cause you pain.
Sleeping on the same side for long periods of time is also not advisable.
In essence, Ayurveda is a pathway to not just symptom relief but also to a balanced state of health that prevents recurrence.
Don’t ignore the pain or stiffness in your shoulder.
With persistence and proper care, you can thaw out the stiffness and reclaim your shoulder’s mobility.
For more details or to know more about the condition and treatment please feel comfortable to call +91-9388099009 or mail sakalyahospital@gmail.com or chat online with our doctors through www.sakalya.com.
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