Frozen shoulder, also known as adhesive capsulitis, is an uncomfortable condition categorized by a thickening of the connective tissue capsule surrounding the shoulder joint, severely limiting shoulder movement. Doctors don’t really know why the condition develops, although it tends to be more common in adults between the ages of 40-60 who have put a fair amount of stress on their shoulders over the years. Diabetics are also at a heightened risk for the condition, and while it tends to develop in just one shoulder, it’s possible that it develops at the same time or in one shoulder and then again years later in the other shoulder.
Frozen shoulder is quite common, and it has a pretty standard course of care as you and your provider work to help the frozen shoulder “thaw.” In today’s blog, we take a closer look at the progression of care for patients dealing with frozen shoulder.
The Treatment Stages Of Frozen Shoulder
There are typically four types of treatment programs that patients may be offered depending on the extent of their frozen shoulder and its responsiveness to treatment. Let’s break down each treatment stage.
- Watchful Waiting – For some patients, all they may really need to do is wait it out. Most cases of frozen shoulder resolve eventually on their own without surgery, and mild cases can resolve within a few weeks. You may simply be told to keep an eye on it for the time being, although most doctors will pair this treatment stage with the next program in an effort to speed up the thawing process.
- Physical Therapy – The second stage of treatment involves a heavy dose of physical therapy and stretching exercises. The goal here is to get the shoulder used to normal movements and slowly expand its comfortable range of motion. If you work to develop flexibility and an extended range of motion, it’s less likely these motions will trigger tissue inflammation in the future. Your shoulder is going to feel stiff and restricted, but weeks of physical therapy can expand your flexibility and help normal movement feel less uncomfortable. Your doctor may also recommend anti-inflammatory medications at this stage or in the above stage, but they may be more effective in this stage, as they’ll work to control inflammation that could develop after physical therapy or inflammation that’s making it difficult to fully pursue your PT exercises.
- Injection – If months have passed and you’re not seeing the progress you had hoped for, connect with Dr. Holloway and learn more about a targeted steroid injection. When conservative means fail, the next step in treatment is an intra-articular steroid injection. This ensures anti-inflammatory medication is delivered to the source, and after a few days, you’ll pair this with some stretching exercises. Dr. Holloway has his patients focus on long, slow stretches, but talk to your doctor for individualized recommendations. This stronger medication and stretching routine can help get you over the hump and avoid the final stage of treatment.
- Surgery – If all else fails, your doctor may recommend a minimally invasive surgical procedure to address the shoulder. The operation is called an arthroscopic extensive debridement capsular release. Tissues are debrided and manually released by your surgeon while a nerve block is in place and the patient is under general anesthesia. Physical therapy will be key to effective recovery after surgery. Stretching and PT exercises begin shortly after the nerve block wears off, as this early motion is crucial for reestablishing flexibility and preventing stiffness and scar tissue formation. Roughly 85% of patients experience significant improvement in their shoulder range of motion following their rehabilitation course, and the majority do not develop the condition later in life in either shoulder.
Let Dr. Holloway and his team find the right course of treatment for your frozen shoulder. We’ll work with you to help thaw the shoulder in the fastest and least invasive way possible so that you can get back to all normal arm motions. For more information on how we can assist with frozen shoulder treatment, or for help overcoming a different shoulder problem, connect with Dr. Holloway’s office today at (865) 410-7887.
