5 Rawatan Terbaik Untuk Sengal Bahu oleh Dr. Sanjiv Rampal, Pakar Orthopaedic, Petaling Jaya, Malaysia.

Dr Sanjiv, what is a frozen shoulder?

Dr. Sanijiv, apakah itu ‘Frozen Shoulder’?

Dr Sanjiv, my parent is having difficulty with overhead activity. What is the treatment option for Frozen Shoulder?

Dr. Sanjiv, ibu/bapa saya kerap mengalami sengal bahu terutamanya apabila mengangkat tangan pada aras atas bahu. Apakah rawatan untuk kondisi ini?

Frozen shoulder is a relatively common shoulder pain condition that often happens when the shoulder is extended. Pain is gradual, and lifestyle is mostly affected especially overhead activities, e.g. reaching out to take something from the top shelf, or to some extent wearing clothes can cause agony.

Frozen shoulder atau dalam Bahasa Melayu ‘Bahu Beku’ merupakan kondisi gejala sakit atau sengal pada bahu semasa bahu diangkat, dan mempunyai tahap kesakitan yang berperingkat. Kebiasaannya, pesakit akan merasa kesakitan yang paling ketara apabila tangan diangkat melebihi paras bahu, sebagai contoh, mengambil barang di tempat yang tinggi, ataupun semasa menukar pakaian juga boleh mengundang keperitan.

The condition manifests in the lining of the shoulder joint, known as the ‘capsule’. It is a very flexible elastic structure which allow the vast range of motion that the shoulder has. This capsule (and its ligaments) becomes inflamed, swollen, red, and contracted with a frozen shoulder. Inevitably, the normal elasticity is lost, pain and stiffness set in.

Gejala sengal pada bahu berpunca dari kantung sendi yang mengalami kecederaan sehingga menjadi bengkak, lalu menjadikan keanjalan pada sendi itu berkurangan. Ianya secara tidak langsung, menjadikan pergerakan bahu itu terbatas ‘frozen’.

A frozen shoulder often starts out of the blue but may be triggered by a mild injury to the shoulder. The condition usually goes through three phases, starting with pain, then stiffness, and finally a resolution stage as the pain eases and most of the movement returns. This process may take a long time, sometimes as long as two or more years. 

Pergerakan bahu yang terbatas mungkin terjadi secara tiba-tiba, atau disebabkan oleh kecedaraan pada sendi bahu. Kondisi ini mempunyai 3 fasa, iaitu pertama, pesakit akan merasa bahu mereka lenguh dan sakit; kedua, pesakit akan merasa sukar untuk menggerakkan bahu, dan akhir sekali ialah fasa pemulihan yang mana kondisi telah beransur pulih membolehkan pesakit menggerakkan bahu dan tanganya kembali. Proses ini mungkin mengambil masa yang lama sehingga boleh mencecah 2 tahun.

Frozen shoulder may be associated with diabetes mellitus, thyroid disease, high cholesterol, heart disease and is also seen in patients with scar tissue in their hands, a condition called Dupuytrens contracture. It may follow an injury to the shoulder or surgery. 

Penyakit lain juga boleh menyumbang kepada kondisi ‘frozen shoulder’ sebagai contoh, diabetes mellitus/kencing manis, penyakit tiriod, sakit jantung dan parut tisu dari penyakit Dupuytrens contracture atau selepas menjalani pembedahan bahu.

Treatment is a prolonged course of aggressive physical therapy and medical management of the underlying disease if present (i.e diabetes, thyroid disorder).

Rawatan berdasarkan simptom ‘frozen shoulder’ dan penyakit yang dialami misalnya penyakit kencing manis atau tiriod.

Manipulation under anaesthesia or arthroscopic capsular release is indicated in patients with progressive loss of motion having failed a prolonged course of physical therapy. 

Manipulasi bahu semasa dalam keadaan bius disarankan kepada pesakit yang tidak pulih dengan cara terapi fizikal dan apabila keadaan menjadi semakin teruk sehingga tidak dapat mengangkat bahu atau tangan.

Dr Rampal recommends the treatment for a frozen shoulder is focused on relieving pain and restoring the shoulder’s normal range of motion. The methods would include.

Dr. Rampal mengesyorkan rawatan berikut untuk mengurangkan kesakitan dan membaik pulih keadaan bahu pesakit.

1. Physical and physiotherapy program of gentle, pain-free stretching of the joint / Program regangan fisioterapi.

2. Thermotherapy with moist heat / Menuam pada bahagian yang sakit

3. Pain relieving medication and Intra Articular steroid injections for reduce inflammation and provide pain relief / Ubat tahan sakit atau anti-radang, dalam bentuk pil atau disuntik terus ke dalam bahu pesakit untuk mengurangkan kesakitan.

4. Manipulation under anaesthesia-where patient is given short acting anaesthesia and joint is manually stretched to release adhesions / Manipulasi bahu secara manual untuk meregangkan bahu semasa pesakit dalam keadaan tidak sedarkan diri.

5. Surgery- Last resort,often reserved to few selected patients where capsular release is done thru keyhole surgery / Pilihan terakhir ialah pembedahan menebuk lubang kecil.

Social & Website Instagram:

https://www.instagram.com/rampalsurgery

Twitter: https://twitter.com/rampalsurgery

Facebook: https://www.facebook.com/rampalsurgeryios

TikTok: https://www.tiktok.com/@rampalsurgerykl

LinkedIn:www.linkedin.com/in/sanjivrampal

Website: https://rampalsurgery.com

Email- rampalsurgeryios@gmail.com

Disclaimer

http://www.Rampalsurgery.com is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their healthcare professionals for any such conditions.