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Frozen shoulder, also called adhesive capsulitis or frozen shoulder syndrome, occurs when the mobility of the shoulder joint is restricted and painful. It is usually caused by a thickening of the connective tissue surrounding the shoulder joint because of scar tissue from a shoulder injury or forced immobility after surgery or injury, but it can also be associated with diabetes, thyroid, or autoimmune diseases. Frozen shoulder manipulation loosens the connective tissue by quickly pushing the shoulder past the restricted point into the normal range in only one to two sessions. Physical therapy for frozen shoulder, in contrast, usually requires many months of rehabilitation. Manipulation is painful and is typically only done under general anesthesia.
During a frozen shoulder manipulation, you will be placed on a table and usually given general anesthesia, although in some cases, local anesthesia may be used to numb the shoulder area. An orthopedic physician will rotate the shoulder above your head and then out to your side until the motion is arrested by the tightened connective tissue. Your scapulae or shoulder blade will be braced and the orthopedic physician will give a quick push to loosen up the bound connective tissue. The physician will then place the shoulder into another position, stabilize the scapulae, and give another quick thrust. Usually, this is performed on all angles of the shoulder that are restricted.
Following the procedure, you will need physical therapy to maintain the enhanced motion and prevent swelling. Physical therapy is typically needed for at least one to three weeks following manipulation. Sometimes, the procedure will need to be performed again to further increase the range of motion.
There are some risks associated with frozen shoulder manipulation that you should consider before agreeing to the treatment. In rare cases, the connective tissue can be torn or further damaged by the forced extension, which increases the chance of scar tissue forming, restricting the movement again. Physical therapy following the procedure can help prevent scar tissue from developing and prevent the return of the restricted movement. The excessive thrusting during the manipulation can also, on occasion, damage the brachial plexus nerve and may also break the humerus, or upper arm bone, and so it is not a viable option for people with osteoporosis. If this procedure does not improve the shoulder movement, arthroscopic surgery is an option to remove the scar tissue.
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