Treatment of Frozen Shoulder

Treatment starts with physical therapy (range of motion exercises). This is the mainstay or the gold standard in all frozen shoulder conditions. Physical therapy ensures that the patient will continue to move the joint despite having a painful shoulder. This is particularly important in the second stage of this condition where the stiffness will be at its maximum and even though the pain is subsiding. Passive stretching of the joint in all directions using the opposite limb is done 3-4 times a day, every day. Assistive devices such as a towel, table or wall, and a broom- or walking-stick could also be used to provide maximum effect (see picture).

Pain can be treated by heat therapy, or analgesics usually prescribed by the treating doctor. This is often unnecessary unless the pain is unbearable and is very much disturbing daily activities. Long-term intake of analgesics is often discouraged.

In conditions where the stiffness cannot be overcome even with frequent stretching exercises, manipulation of the shoulder (where the surgeon will ‘break’ the thickened capsular tissue by forced movement under general anesthesia) is an option. Often a surgery is not needed after this procedure, unless the stiffness is persistent. In this rare instance, the surgeon will perform an arthroscopic capsular release whereby the thickened capsule is divided under direct vision (using an arthroscope – see picture below).