Rajesh K. Sharma, MD
Unlike the beauty of the Arctic, there is nothing wonderful about having a shoulder that does not have full range of motion. Not only is it painful, it also can be quite debilitating.
The condition is commonly associated with diabetes. Many times, it comes as a consequence of an injury and lack of movement that follows. You recover from your injury, and then “whammo!” your shoulder doesn’t move the way it used to. Sometimes, these symptoms can improve with conservative measures, oftentimes not. So, what can be done about this?
Treatment
Non-Surgical
- NSAIDs: Drugs like aspirin and ibuprofen are anti-inflammatory and can help reduce pain and inflammation
- Steroid Injections: Injections of a corticosteroid mixed with a local anesthetic may be injected into the shoulder joint or into the Suprascapular Notch to allow relief of symptoms sufficient to permit better results in Physical Therapy
- Hydrodilatation: This technique involves injecting a volume of sterile saline (up to 50 mL) mixed with a local anesthetic to expand and stretch the shoulder joint capsule. This procedure is done by the physician under fluoroscopic guidance to ensure appropriate spread and effect of the medication. This technique is effective in improving range of motion in at least 70% of patients, and reducing pain in 90%.
Afterwards going to physical therapy and performing home exercises will be essential for maintaining the improvement in the range of motion appreciated after having the Hydrodilatation performed.
Surgical
- Manipulation under Anesthesia: This is where you will be placed under anesthesia and the surgeon will manipulate your shoulder in a manner which will cause the scar tissue to stretch or tear. Studies have shown that this method has equivalent results when compared with Hydrodilitation.
- Shoulder Arthroscopy: The surgeon will use an arthroscope to visualize the affected tissue and use an instrument to lyse the adhesions in the joint capsule.
If your shoulder doesn’t move like it used to, and conservative measures have not been helpful, lets talk about what we can do to get you moving that arm right again!
Online References
Here are a couple of useful online sources to review more information about what a frozen shoulder is: