Treating Frozen Shoulder

Frozen shoulder (adhesive capsulitis) typically improves over time, with or without treatment, but treatment can help decrease the severity of pain and other symptoms and speed up the healing process. ¹ Manske RC, Prohaska D. Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med. 2008;1(3-4):180-9.

See The P.R.I.C.E. Protocol Principles

Without treatment, symptoms usually go away in about two years. ² Frozen Shoulder. MedlinePlus website. https://www.nlm.nih.gov/medlineplus/ency/article/000455.htm. Last updated November 2014. Accessed May 29, 2016. More than 90% of people with frozen shoulder get better with nonsurgical treatment, such as physical therapy and anti-inflammatory medicines, such as ibuprofen. ³ Frozen Shoulder. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00071. Last reviewed January 2011. Accessed May 19, 2016. If symptoms do not diminish or resolve with time and nonsurgical treatments, surgery may be an option.

Nonsurgical Treatment

There are several nonsurgical treatment options available for frozen shoulder. These include:

Non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, can help decrease swelling and pain.

Physical therapy exercises and stretches designed to help increase shoulder motion. A person may be given an exercise program to complete at home or attend prescribed physical therapy appointments. Progress may be slow. It can take anywhere from weeks to months to see improvement.

See Frozen Shoulder Exercises for Pain Relief

Steroid injections are given into the shoulder joint. Steroid injections decrease inflammation in the shoulder joint. Reduced inflammation usually leads to reduced pain and allows for the therapist to stretch the shoulder. It may take a few days before pain decreases, and the pain reduction may last for weeks or be long-term.

See Treating Acute Sports and Exercise Injuries in the First 24 to 72 Hours

Surgery and Procedures

If nonsurgical treatment is ineffective and symptoms persist, there are other options to consider.

Shoulder arthroscopy. This is a common procedure when the physician cuts through the abnormal, adhesive tissue in the shoulder joint capsule. The procedure is designed to increase shoulder range of motion and shoulder movement. After surgery a patient is usually prescribed physical therapy.

See Shoulder Decompression: Arthroscopy vs Open Surgery

Manipulation under anesthesia. While the patient is under anesthesia, the physician moves the affected shoulder in multiple directions—tearing and breaking up scar tissue in the shoulder joint capsule.

See Rotator Cuff Repair Surgery

Both of these procedures carry possible risks and complications, such as a minor risk of infection and possible fracture from manipulation of a stiff shoulder. Patients and physicians must weigh the pros and cons of having surgery versus potential risks.

After surgery, patients typically require daily therapy for the first two weeks after surgery and will be given exercises to perform at home to prevent adhesions from developing. It is recommended to continue these exercises for 12 months following the surgery.