Frozen Shoulder Pain Release Treatment Recovery

What Happens When You Have Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition where the shoulder joint becomes stiff and painful, severely restricting its movement. This typically occurs in three phases: freezing, frozen, and thawing. The symptoms include: ( vid new- How would I know that I have developed Frozen Shoulder?)

• Pain: Initially, you may feel a dull or aching pain, which worsens with movement.
• Stiffness: Gradually, the shoulder becomes stiffer, making it harder to move your arm.
• Restricted Range of Motion: As the condition progresses, you may find it difficult to perform everyday tasks such as reaching overhead or behind your back.
• Pain at Night: Pain may intensify at night, causing disturbed sleep.

Frozen shoulder can develop without a clear cause, but it is commonly associated with injury, overuse, or underlying health conditions like diabetes or thyroid disorders.

What Is Frozen Shoulder Release Surgery?

Frozen shoulder release surgery, also known as shoulder arthrolysis or manipulation under anesthesia (MUA), is performed when non-surgical treatments fail to improve shoulder mobility and pain. The goal of the surgery is to release the tight, thickened capsule around the shoulder joint to allow for a wider range of movement. There are two main types of surgeries: ( vid new- Surgeries for frozen shoulder?)

1. Arthroscopic Shoulder Release

In this minimally invasive procedure, the surgeon uses small incisions and a camera (arthroscope) to guide them in cutting or removing the stiffened capsule and other inflamed tissues surrounding the joint.

2. Manipulation Under Anesthesia (MUA)

This involves the surgeon manipulating the shoulder while the patient is under general anesthesia. The goal is to break up the adhesions (scar tissue) that have formed inside the joint, which causes the stiffness.

Does Frozen Shoulder Require Surgery?

Not all cases of frozen shoulder require surgery. Most people experience gradual improvement over time with physical therapy, medication, and other conservative treatments. Surgery is typically recommended for those who:

• Have severe pain that does not improve with medication.
• Have a significant restriction in the range of motion.
• Are unable to function normally due to shoulder stiffness.

Surgical intervention may also be necessary if the condition persists for more than a year without improvement through non-invasive treatments.

What Are the Symptoms of Frozen Shoulder?

The symptoms of frozen shoulder develop gradually and may worsen over time. They are categorized into three stages:

1. Freezing Stage

This is the initial phase, where the shoulder begins to hurt more, especially at night. The pain progressively limits the shoulder’s range of motion.

2. Frozen Stage

The pain might decrease but the shoulder becomes very stiff. The range of motion is severely restricted, and you may find it difficult to perform routine activities.

3. Thawing Stage

This is the recovery phase, where the shoulder gradually begins to regain its range of motion. This process can take several months.

Additional symptoms include:

• Difficulty reaching overhead or behind the back.
• Pain when moving the shoulder, especially with overhead motions.
• Tenderness around the shoulder joint.

Does Frozen Shoulder Surgery Lead to Total Shoulder Replacement?

Frozen shoulder surgery typically does not lead directly to the need for total shoulder replacement. However, in rare cases, if the joint is severely damaged or the patient has underlying arthritis, shoulder replacement may be considered in the long term. After the shoulder release surgery, most patients regain significant function, but if arthritis or degenerative changes are present, a replacement may eventually be needed.

Treatment Procedure for Frozen Shoulder Release Surgery

The treatment for frozen shoulder depends on its severity and the patient’s condition. Here are the main treatment options:

1. Home Remedies and Conservative Treatment

Initial treatment for frozen shoulder typically involves:

• Rest: Reducing movement can help minimize irritation and inflammation.
• Heat/Cold Therapy: Applying a hot compress or cold pack to the shoulder may reduce pain and swelling.
• Over-the-counter Medications: Anti-inflammatory drugs like ibuprofen can help alleviate pain and reduce swelling.
• Physical Therapy: A physiotherapist will guide the patient through gentle stretches and exercises to improve shoulder mobility and relieve stiffness.

2. Corticosteroid Injections

In some cases, corticosteroid injections may be used to reduce inflammation and relieve pain. These injections provide temporary relief and help with physical therapy exercises.

3. Frozen Shoulder Release Surgery

If conservative methods fail, surgery may be recommended. The treatment for frozen shoulder release surgery involves:

• Arthroscopy: The surgeon inserts a small camera and surgical instruments through tiny incisions to release the scar tissue and adhesions within the shoulder joint.
• Manipulation Under Anesthesia: If arthroscopy is not sufficient, MUA may be performed to break up adhesions and release the joint.

Preparation for Frozen Shoulder Treatment

Before undergoing surgery for frozen shoulder, the doctor will perform several evaluations, which may include:

• Physical Examination: To assess the range of motion, pain levels, and shoulder function.
• X-rays: To rule out any underlying conditions such as arthritis or fractures.
• MRI or Ultrasound: To better understand the extent of damage to the shoulder joint and soft tissues.

Preparatory Steps Before Surgery

• Discuss Treatment Options: Review all available treatment options with your doctor and address any questions or concerns.
• Fasting Before Surgery: You may be instructed to refrain from eating or drinking after midnight before the surgery.
• Medication Disclosure: Inform your doctor about any medications, supplements, or health conditions, as some medications, like blood thinners, may need to be stopped prior to surgery.
• Stop Smoking and Alcohol: Avoid smoking and alcohol consumption for several days before surgery to promote healing.
• Physical Therapy: Some patients may need pre-operative physical therapy to improve shoulder strength and mobility.

Post-Operative Protocol for Frozen Shoulder Release Surgery

Recovery after frozen shoulder surgery requires careful management and rehabilitation. Patients are typically discharged the same day or after a short hospital stay. Here’s what to expect:

Immediate Post-Op Care:

• Rest: Adequate rest is crucial for healing and to avoid stressing the shoulder joint.
• Pain Management: Painkillers prescribed by the doctor can help manage post-surgical pain.
• Ice Packs: Apply ice to reduce swelling and pain.
• Arm Sling: You may be required to wear a sling for a few days after surgery to immobilize the shoulder.

Physical Therapy:

• Early Movement: Gentle movements and stretching exercises are encouraged to prevent stiffness and aid recovery.
• Strengthening Exercises: A physical therapist will guide you through exercises to improve muscle strength and joint function.
• Return to Activities: Most patients can resume light activities within a few weeks, but strenuous physical activities or heavy lifting should be avoided for at least 3-6 months.

Follow-Up Appointments:

• Regular follow-ups will be necessary to monitor your progress and ensure proper healing.

Risks and Complications of Frozen Shoulder Surgery

Although frozen shoulder release surgery is generally safe, it carries some risks and potential complications:

• Infection: As with any surgery, there is a risk of infection at the incision site.
• Stiffness: Some patients may experience residual stiffness even after surgery.
• Nerve Injury: Rarely, nerves may be damaged during the procedure.
• Blood Clots: There is a risk of blood clots, particularly after surgery.
• Recurrent Adhesions: In some cases, the adhesions may return, leading to a recurrence of frozen shoulder.

Frozen Shoulder Release Surgery Cost in India

The cost of frozen shoulder release surgery in India varies widely depending on several factors, including the city, the hospital, and the surgeon’s expertise. On average, the cost ranges between INR 50,000 and INR 3,00,000. Factors that affect the cost include:

• Type of Surgery: Arthroscopic surgery is generally more affordable than open procedures or manipulation under anesthesia.
• Hospital Choice: Multispecialty private hospitals tend to charge higher fees than government or smaller private hospitals.
• Surgeon’s Expertise: Experienced surgeons with specialized training may charge higher consultation and surgical fees.
• Geographical Location: Larger cities like Delhi, Mumbai, and Bangalore generally have higher treatment costs compared to smaller towns.
• Insurance Coverage: Insurance may cover part of the surgery, reducing out-of-pocket costs.

Qualities of a Top Shoulder Surgeon

When choosing a shoulder surgeon, look for the following qualities:

• Board Certification and Specialization: The surgeon should be certified in orthopedic surgery with specialization in shoulder treatments.
• Experience: A highly experienced surgeon will have a better track record with complex cases.
• Reputable Hospital: Choose a surgeon affiliated with a hospital known for quality care and successful outcomes.
• Patient Care: The surgeon should be compassionate, listen to your concerns, and provide clear, understandable explanations about the treatment plan.
• Up-to-date Skills: A top surgeon stays informed about the latest technologies and surgical techniques for treating frozen shoulder.

How to Choose the Best Shoulder Surgeon

Here are some tips to help you choose the best shoulder surgeon for your treatment:

• Seek Referrals: Ask friends, family, and primary care doctors for recommendations.
• Check Reviews: Online patient reviews and testimonials can provide insight into the surgeon’s skill and bedside manner.
• Verify Credentials: Ensure the surgeon has proper certifications and a clean professional record.
• Consultation: Schedule a consultation to discuss your case and gauge your comfort with the surgeon’s approach.
• Insurance: Check if the surgeon accepts your insurance to minimize out-of-pocket expenses.