Frozen Shoulder >> Treatment

How is frozen shoulder treated?

Non-Operative Treatment

For most patients with primary adhesive capsulitis, a supervised physical therapy program can help restore lost motion, although it can take six to eighteen months to accomplish this. It is often necessary to combine a home program with supervised physical therapy for maximum gains.

Shoulder stiffness that results from secondary adhesive capsulitis is generally more resistant to non-operative treatment. A supervised physical therapy program is always tried first. However, even an aggressive stretching program with an experienced therapist is often ineffective when frozen shoulder follows an injury or previous surgery.

In some cases, non-steroidal anti-inflammatory medications can be helpful with this condition. Other treatments such as ice, heat, and ultrasound may help alleviate some of the pain. These treatments are recommended as long as they are effective.

Supervised tor home herapy programs continues as long as the patient is making improvement. If the patient is not improving operative treatment may be considered. The expected time for resolution of frozen shoulder varies depending on the underlying causes and from patient to patient. The decision to undergo surgical treatment is made on a case by case basis depending on many factors. These include the cause of the frozen shoulder, the duration of treatment and underlying medical conditions.

Operative Treatment

Operative procedures to treat frozen shoulder include closed manipulation, as well as arthroscopic and open surgical techniques. Operative treatment of primary adhesive capsulitis should only be considered once severe pain has subsided, and discomfort is present only at the extremes of motion. Severe pain represents the inflammatory stage of the disease. Surgery during this inflammatory phase may actually increase injury to the joint capsule, adding to the patient’s loss of motion. Arthroscopic release of the contracted shoulder tissue is preferred by your physician as opposed to closed manipulation of the shoulder. This is because arthroscopic release is more precise and typically restores better motion than simply tearing the contracted tissues with a closed manipulation.

Most patients who have not done well with a non-operative therapy program will do well with a closed manipulation or an arthroscopic capsular release procedure that is followed by aggressive motion therapy.

Arthroscopic Capsular Release

Arthroscopic capsular release has proven to be a safe, effective way to release the scar tissue from the capsule. During an arthroscopy, a small fiberoptic instrument is inserted into the joint. The scar tissue surrounding the joint is removed and a gentle manipulation follows. This will significantly reduce the risk of fracture or injury if the frozen shoulder has been present for some time. If necessary, other disorders within the shoulder can be addressed at the same time.

Open Release

On rare occasions, an open procedure to release the adhesions may be required. This may be the case if tightening is present between tissues outside the joint capsule that are not accessible with arthroscopy. Patients who have had previous surgery or a severe joint injury are often candidates for an open release.

What types of complications may occur?

Complications after frozen shoulder surgery are generally infrequent. The most common problems associated with any of these procedures result from too little release, which fails to adequately reduce stiffness, or (very rarely) from too much release, which may cause shoulder instability. Fractures of the humerus have been reported with closed manipulation. Older patients with fragile bones (osteoporosis) are more at risk for this type of complication. In rare cases, previous surgical repairs have been damaged. Although arthroscopic releases are relatively safe, releases in certain areas inside the joint have led to nerve injury.


Cross Arm Push
Place the hand on the opposite shoulder. The other hand should be used to pull the elbow across the body until there is a good stretch on the back of the shoulder.