Question:I somehow managed to get a frozen shoulder. No one seems to know what caused it. My doctor has suggested a wait-and-see approach. She says these things tend to take care of themselves, and that it will probably go away on its own. Isn't there something I could or should be doing to get better?
Answer:A stiff and painful shoulder with limited motion is known as a frozen shoulder. It can be the result of trauma, diabetes, or from unknown causes. The condition does tend to follow the rule of threes. It has three stages that each last about three months.
The first stage is the freezing phase. The arm starts to lose motion and become painful. The second stage is the frozen phase. The pain is less but stiffness prevents functional movement. This phase lasts at least three months (sometimes longer). In the final stage, the shoulder starts to thaw. Range of motion slowly returns to normal.
The wait-and-see approach is sometimes referred to as benign neglect or supervised neglect. This treatment method seems to work about as well as any other. Some patients prefer to seek the services of a physical therapist to help them regain motion and strength.
Other forms of conservative (nonoperative) treatment may include cortisone injections, oral steroids, or nerve block. Manipulation (movement) of the shoulder can be tried under anesthesia before surgical release of the capsule is considered.
Studies have not been done to show which approach works best -- or if any treatment is really even needed. Until proven differently, the wait-and-see management style is considered acceptable at this time.Dennis Liem, MD, et al. The Influence of Arthroscopic Subscapularis Tendon and Capsule Release on Internal Rotation Strength in Treatment of Frozen Shoulder. In The American Journal of Sports Medicine. Vol. 36. No. 5. Pp. 921-926.
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