Adhesive capsulitis
Treatment involves non-steroidal anti-inflammatory medications (NSAIDs), steroid injections, and physical therapy. It can take as long as 12-18 months to see improvement. The physical therapy is intense and needs to be done every day. Steroid injections can significantly improve the results of physical therapy.
If therapy is not successful, or if a patient can not tolerate therapy, a shoulder manipulation may be performed. This procedure is done under anesthesia. The health care provider will forcibly bring the shoulder through a range of motion to release the scar tissue.
Arthroscopic surgery can be used to cut the tight ligaments and remove the scar tissue from the shoulder. Some surgeons may use repeated pain blocks after surgery so the patient can participate in physical therapy after surgery.
With therapy and NSAIDs, the problem will usually resolve within a year. When required, surgery is usually successful in restoring motion, but therapy must be continued for several weeks to months after surgery to prevent recurrence. The most common reason for any treatment to fail is non-compliance with therapy.
Complications include persistent stiffness and pain despite therapy. If there is forceful manipulation of the shoulder during surgery, the arm can break.
If you have shoulder pain and stiffness and suspect you may have a frozen shoulder, contact your health care provider for proper referral and treatment.
Sheridan MA, Hannafin JA. Upper extremity: emphasis on frozen shoulder. Orthop Clin North Am. 2006 Oct;37(4):531-9. Review.
Brue S, Valentin A, Forssblad M, Werner S, Mikkelsen C, Cerulli G. Idiopathic adhesive capsulitis of the shoulder: a review. Knee Surg Sports Traumatol Arthrosc. 2007 Feb 28; [Epub ahead of print].