Trail of Treatment for Frozen ShoulderPain relievers. Injections. Steroids. Physical therapy. Stretching. Strengthening. That's the trail of treatment for adhesive capsulitis otherwise known as a "frozen shoulder." When it's truly "stuck," manipulation may be needed. It can be a long, frustrating journey for the patient.
This is a report of 40 patients with resistant adhesive capsulitis. All were treated with manipulation and release of the joint capsule. A rehab program followed.
In a manipulation, the patient is anesthetized. The surgeon moves the patient's shoulder through its full range of motion. The arm is relaxed, and scar tissue is popped or torn as the joint moves freely. The surgeon may also use an arthroscope to reach inside the joint and cut the capsule loose. This release prevents bone fracture, torn muscles and tendons, and dislocations that can occur with shoulder manipulation.
The results of this treatment were measured by stiffness, pain levels, motion, and function. An important focus of this study was the method and timing of physical therapy (PT) after the operation. In this study, PT started the first day after surgery. Rehab went through two phases over three months.
The authors conclude that the combined treatment of manipulation, capsular release, and early rehab works well in rare cases of resistant frozen shoulder. The patients regained most of their shoulder motion and were very happy with the results.
Gianluca Castellarin, MD, et al. Manipulation and Arthroscopy Under General Anesthesia and Early Rehabilitative Treatment for Frozen Shoulders. In Archives of Physical Medicine and Rehabilitation. August 2004. Vol. 85. No. 8. Pp. 1236-1240.
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