Q: I have a frozen shoulder that just isn't getting better. I've heard they can put you to sleep and manipulate the joint. Is there some other easier way to get the motion back without that kind of trauma?
A: Manipulation under anesthesia has the advantage of restoring shoulder motion without using an open incision. But it does have the disadvantage that it is tearing or rupturing the tight, scarred down joint capsule.
If you haven't tried the conservative route of physiotherapy, you might want to consider that course of treatment before looking into surgical options. Physiotherapy can help you regain lost shoulder motion while paying attention to your posture and alignment.
You will be given a home program to follow. Cooperation with the exercises and activities recommended by the therapist will ensure a successful outcome. Stretching exercises to increase flexibility will be followed by strengthening exercises to restore strength.
The physiotherapist will show you ways to move that will avoid impingement (pinching of the muscles and tendons around the joint). Helping you change movement patterns and poor postural habits can also go a long way in preventing a relapse.
If you have completed a course of therapy and exercise without improvement, then arthroscopic surgery might be the next step. Although the surgeon inserts the scope into the joint, an open incision is not required.
Instead of the uncontrolled tearing of the capsule with manipulation under anesthesia, the surgeon can use the arthroscope to release the capsule slowly and gently. If there are any bone spurs or inflamed synovial tissue, the surgeon can also remove these at the same time.
Talk with your orthopedic surgeon about your treatment options. Let him or her know you are interested in a less traumatic approach. Many patients get good results without the trauma of manipulation or open incision surgery.
Reference: Michelle M. Gosselin, et al. Meeting the Challenge of Chronic Shoulder Pain: Treatment. In The Journal of Musculoskeletal Medicine. November 2010. Vol. 27. No. 11. Pp. 441-445.
Elite Physical Therapy & Rehabilitation Centre provides services for physiotherapy in North Vancouver.
