Frozen Shoulder: Common and Treatable
Marked by shoulder pain, stiffness and limited range of motion, adhesive capsulitis is a common condition often seen after prolonged immobilization, such as after injury or surgery. Also known as frozen shoulder, proper diagnosis and treatment require a trip to the orthopedic surgeon.
The shoulder joint is encased by a capsule of tissue, explains orthopedic surgeon, Dennis Sagini, M.D. When the capsule becomes inflamed, and it thickens and tightens around the joint, the patient complains of shoulder pain and has trouble with certain arm movements, like external rotation or forward elevation.
At that point, it is best to see an orthopedic surgeon. Dr. Sagini says he reviews a patient s medical history, evaluates past injuries and performs a physical examination. Patients also get an X-ray, and, if necessary, an MRI.
Once diagnosed, the first method of treatment is physical therapy (PT), he says. PT in the office with a physical therapist is good because it pushes the patient beyond his or her comfort level and helps increase mobility. If, after 4-6 weeks, there isn t improvement, then we move on to cortisone shots which helps reduce pain and inflammation while continuing with PT.
Surgery is the last option, but may be necessary if a patient does not improve after the combination of cortisone shots and PT, Dr. Sagini says. Surgical methods include:
- Manipulation under anesthesia, which involves the surgeon moving the shoulder while the patient is under anesthesia to help loosen the tightened tissue.
- Manipulation under anesthesia with shoulder arthroscopy, which allows the surgeon to insert tubular instruments through small incisions in order to evaluate the muscles, tendons and tissues. This method helps the doctor see if there are other issues that could have caused the frozen shoulder and lets him or her address those issues, too.
There is not an exact known cause of frozen shoulder, Dr. Sagini says. It is important, if you have a shoulder injury or surgery, to follow doctor s orders with regard to downtime and PT because you don t want to keep the joint immobilized and allow inflammation, thickening and tightening of the tissue.
Dr. Sagini says there may be other factors, including genetics or other medical conditions, like diabetes, that can cause frozen shoulder. Nevertheless, regardless of the cause, shoulder or other musculoskeletal pain should be evaluated by an orthopedic surgeon for appropriate diagnosis and treatment.
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Dennis Sagini, M.D.
Joint Implant Surgeons of Florida
7331 College Parkway,
Fort Myers, FL 33907
*An outpatient department of Lee Memorial Hospital