The primary treatment considerations include oral anti-inflammatories, physical therapy for aggressive range of motion, glenohumeral distension and corticosteroid injection. If symptoms fail to improve with these options after an extended period of time, consideration could be given to manipulation under anesthesia.
Frozen shoulder or adhesive capsulitis typically occurs in 3 stages. These include a painful stage, freezing stage, thawing stage. Range of motion is lost in all directions particularly with internal rotation, external rotation, and extension. It can sometimes be associated with underlying thyroid disease or diabetes. The capsule of the glenohumeral joint/synovium collapses or adheres to the joint restricting is range of motion. A common treatment utilized which can accelerate improvement combines glenohumeral distension with lidocaine in corticosteroid with a suprascapular nerve block. The Suprascapular nerve supplies the joint capsule and when anesthetized can reduce pain. The symptoms can last for 3-6 months and return to normal range of motion.
Manipulation under anesthesia. During this procedure, you are put to sleep. Your doctor will force your shoulder to move which causes the capsule and scar tissue to stretch or tear. This releases the tightening and increases range of motion.
Shoulder arthroscopy. In this procedure, your doctor will cut through tight portions of the joint capsule. This is done using pencil-sized instruments inserted through small incisions around your shoulder.