A frozen shoulder, also known as adhesive capsulitis, happens when a person has a stiff shoulder and it cannot be moved through a full range of motion passively or actively. It is not painful as long as the arm is not being moved around. If the shoulder is forced to move in the range where the stiffness is present, it is very painful.
Non-Surgical Treatment for Frozen Shoulder
The mainstay of treatment for frozen shoulder involves reduction of the inflammation with an oral anti-inflammatory medication or a cortisone injection with concurrent physical therapy or home exercise program. Most frozen shoulders can be treated successfully this way.
Surgical Treatment for Frozen Shoulder
If this nonsurgical treatment fails, surgical treatment is the next option. Surgery for frozen shoulder can range from a simple closed manipulation under anesthesia to surgical resection of the scar tissue and capsule release.
A closed manipulation involves the patient having an interscalene nerve block placed by the anesthesia doctor before the procedure. The interscalene block will allow the shoulder to be numb for 12 to 18 hours after the procedure. A very light anesthesia is administered and the orthopedic surgeon will move the shoulder through a full range of motion in four different planes.
Typically a cortisone injection is given at the end of the procedure. The whole procedure generally takes 2 to 5 minutes to perform. After the procedure, while the interscalene block is still functioning and the arm is numb, a visit to the physical therapist occurs. This allows for further stretching of the structures around the shoulder.
Another option is to surgically resect the scar tissue and release the capsule surrounding the shoulder joint. This can be performed arthroscopically. This is a true surgical procedure where incisions are made and a shoulder scope is inserted into the shoulder joint. A shaver or cautery device is used to re-sect the scar tissue and open up the capsule surrounding the shoulder joint.
Latest Research on Frozen Shoulder Treatment
A study published in the August, 2013 issue of the Journal of Shoulder and Elbow surgery compared the two methods for treating a frozen shoulder (adhesive capsulitis). Comparing a closed manipulation under anesthesia versus arthroscopic lysis of adhesions, Dr. John Grant and colleagues performed a systematic review of the published literature. The review found that the data available demonstrated little benefit for a capsule release versus a simple closed manipulation of the shoulder. Further research is recommended in this area.