Frozen shoulder or adhesive capsulitis is a condition in which the shoulder joint becomes stiff and painful. The signs of the condition usually start slowly. They worsen over a period and subsequently resolve between one to three years.
The risk of frozen shoulder development heightens if the patient is recovering from a medical condition or procedure that does not allow them to move their arm, such as a mastectomy or stroke.
Frozen shoulder treatment involves range-of-motion exercises, and at times, the doctor will inject numbing meds and corticosteroids into the joint capsule. In a small number of cases, the patient may require arthroscopic surgery to make the joint capsule loose enabling it to move more freely.
It is not common for a frozen shoulder to occur again in the same shoulder. However, some patients may develop this condition in the opposite shoulder. Thomas & Bigler Knee & Shoulder Institute, led by board-certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada and surrounding locations in The Sagebrush State.
Stages of Frozen Shoulder
The shoulder capsule becomes thick, stiff, and tight in case of a frozen shoulder. Thick tissue bands, known as adhesions, develop. There is insufficient synovial fluid in the joint in many cases.
The main symptoms of a frozen shoulder are severe pain and the inability to move the shoulder, even with assistance. A frozen shoulder develops in the following three stages:
Stage 1: Freezing
The patient slowly experiences incremental pain in the “freezing stage.” The shoulder loses its range of movement as the pain level worsens. This stage usually lasts for six weeks to nine months.
Stage 2: Frozen
During this stage, the pain may actually reduce. However, the shoulder remains stiff. Routine activities may become insurmountable in the four to six months of the “frozen” stage.
Stage 3: Thawing
In the “thawing” stage, the shoulder movement gradually gets better. It takes between six months to two years to return to the normal or close to normal range of motion and strength.
This condition commonly improves over time. However, it may take up to three years to resolve. The goal of the treatment is pain control and the restoration of strength and motion by physical therapy.
A majority of individuals with frozen shoulder respond to simple treatments, oral meds, and physical therapy to address the pain and restore movement.
The doctor may discuss surgery with the patient if therapy and other conservative methods are unable to relieve their frozen shoulder symptoms. Notably, the patient should discuss their potential for recovering with continued conservative treatments, and the risks associated with a surgical procedure.
Frozen shoulder surgery is usually recommended in “Stage 2: Frozen.” The surgery aims to stretch and release the stiff joint capsule. Manipulation of the shoulder under anesthesia and shoulder arthroscopy are common techniques for treating this condition.
Manipulation under anesthesia
In this procedure, the patient is made to sleep. Subsequently, the doctor will force the patient’s shoulder to move. This will cause the scar tissue and capsule to stretch and tear. This helps release the tightening and improves the range of motion.
In this surgical procedure, the doctor will slice tight parts of the joint capsule with pencil-sized instruments via tiny incisions placed on the shoulder. Experienced orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and nearby areas.
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