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Frozen Shoulder
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Q:
I am 39 years old, and I broke my humerous on July 4, 2001. From immobilization, my shoulder froze. I have been getting PT for 10 weeks with not much improvement. My Orthopedic Surgeon mentioned manipulation. Can you tell me about that and what you think of it, or if I should give PT more time?
Answered by
David Bailie M.D.
on December 18, 2001
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A:
Frozen shoulder after trauma can be difficult to treat. Aggressive rehab is the first thing to do. If it shows improvement (even if not complete), then that is continued until no improvement is seen for 1 full month. Surgery is the next step and manipulation is the standard. However, it does not always address other associated problems such as rotator cuff tears (partial or full), cartilage injury etc. Therefore, Arthroscopic surgery is now the recommended treatment so that all problems can be addressed. This includes a “selective capsular release” which is basically a surgically controlled manipulation instead of “tearing” the capsule. The recurrence rate is much less. Patients with diabetes and hypothyroidism universally have a higher recurrence and may also get this on the other side.
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Q:
I have been diagnosed with frozen shoulder and have been in the acute stage for at least 3 months now. I had a cortisone shot which didn't help. I had months of PT, ultrasound, electric stimulation, medication ionizing, etc. I know that the acute stage can last anywhere from 5 to 8 months. Sometimes my arm and hand will go cold; it usually only lasts for a few minutes. My arm, shoulder blade, and neck area are very painful, and it looks and feels like my arm and wrist are swollen. I also get this thick, heavy sensation in my hands and arm. I do exercises even though they are painful. I don't have much mobility in the arm now. Do you think I should pursue an MRI? Do others who get frozen shoulder also have some of these symptoms?
Answered by
David Bailie M.D.
on December 18, 2001
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A:
The symptoms described ar every common with frozen shoulder. An MRI may help to rule out rotator cuff tear, which should be repaired and can stimulate frozen shoulder. If you can wait 5-8 months, and there is not a cuff tear, rehab can continue. If it is too painful and symptoms have not improved over 3 months, surgery may be helpful – specifically arthroscopic evaluation and capsular release.
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Q:
What treatments are available for people who suffer frozen shoulder after having a mastectomy? I currently have very little movement in my left shoulder and am therefore suffering with lymphedema as well.
Answered by
David Bailie M.D.
on December 18, 2001
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A:
This can be very troublesome and initially should be managed with therapy. If it has not improved by 3 months, surgery can be considered-manipulation or capsular releases with arthroscopy. However, surgery with lymphedema is more difficult and has higher risks and therefore, this should be discussed specifically with your surgeon.
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