### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello I have been diagnosed with RA for the past 22 years; along with that I have a frozen shoulder. My specialist has advised that I should do the surgery in order to gain mobility in both of my shoulders. I am hesistant to do this procedure. Is there an alternate route that I can take?What natural supplement(s) would you recommend.

### output:

**1. Frozen shoulder [adhesive capsulitis] can occur independently or due to autoimmune disease [RA in your case], and since diagnosis is usually clinical, and it is often self-limited, observation and reassurance may be considered, but because of the painful and debilitating nature of the disease, it may not be acceptable to some patients.2. Since your specialist advised for surgery, it might be possible that your range of motion/movement might be/is compromised.3. As problem of RA is chronic, thus seek opinion of Rheumatologist regarding specific examination and investigation to know the progress of disease, and if RA comes out to be provoking factor for frozen shoulder, alleviate it first.4. Because there is inflammation resulting in thickening of the capsule thus shot ha heir Nikita [anti-inflammatory measures]. Diabetic myopathy although occurs in lower limb, however, when symptoms involve the shoulder girdle, it must be considered in the differential diagnosis of shoulder painful conditions [because it is a Predisposing factor. In Ayurveda, we treat frozen shoulder on the line of Avabahuka:. Initially Chat Doctor. . Successful and result oriented prescription is:I. Vatakulantak RAS, Basra RAS, panchamrit Laura juggle.II. reason sure, dashmoola arista.III. Erand Paris. Lesson sheer PAK. Avoid eating spicy, fried, pungent and oily foods. [The aim of the Ayurveda treatment is to bring the vitiated data in equilibrium. The most popular Kerala therapy is pizhichil, you may ask an experienced Panchkarma Doctor about the same]