Frozen Shoulder

What is a Frozen Shoulder?

A Frozen Shoulder (Adhesive Capsultis) occurs when the shoulder joint becomes increasingly painful and stiff without any obvious history of shoulder injury or without any sign of a degenerative disease such as arthritis. The process that causes this condition is caused by the thickening and fibrosis of the capsule surrounding the shoulder joint.

Why does a Frozen Shoulder occur?

A Frozen Shoulder usually occurs when the supporting capsule of cartilage and ligaments surrounding the shoulder become so thickened and contracted that they cause partial or full restriction of the joints rotation and movement.

The true cause of this condition is not yet fully understood although it is more commonly seen in women between the ages of 40 and 70 years, especially in those also suffering with Diabetes, Cardiac, Thyroid or Parkinson's disease. 

How is a Frozen Shoulder treated without surgery?

Physiotherapy aimed at gradually and progressively manipulating and relaxing the fibrosed shoulder capsule in combination with the regular use of painkillers and anti-inflammatory medications can be successful in many early stages of this condition. There are typically three stages to this condition: -

Stage 1: The 'freezing' stage, which results in a dull aching shoulder, which becomes worse on attempted movement or exercise. This stage can last from anything between 6 weeks to 9 months

Stage 2: The 'frozen' stage is typically marked by a slow improvement in pain, although some joint stiffness usually remains for 4 - 9 months.

Stage 3: The 'thawing' stage is known as the progressive improvement of shoulder motion and reduction in joint pain until the joint returns to its normal state. This stage can last for anything between a 5 and 24 month period.

How is a Frozen Shoulder treated with surgery?

A surgical procedure to resolve a Frozen Shoulder is typically avoided for all but the most severe and debilitating cases that have repeatedly failed to respond to conservative treatment. In these cases, surgical intervention is aimed at stretching and releasing the contracted shoulder joint capsule.
This can be achieved by: -

a) Manipulating and forcing the affected shoulder joint through a full range of movement under anaesthetic or
b) By performing a Shoulder Arthroscopy and cutting through the fibrosed parts of the affected joint capsule.
c) By performing both of the above described procedures in combination.    

What is the recovery like?

Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as active and mobile as possible to avoid joint stiffness and other complications such as Deep Vein Thrombosis (DVT) from developing. It is therefore normal for patients to be encouraged to take a short walk and perform gentle postoperative exercises with guidance from a physiotherapist on the day of surgery.

Following a progressive improvement of mobility and pain control patients are normally discharged from hospital 1-2 days following surgery. By the time the required level of recovery is achieved for discharge, patients are normally fully mobile, wearing a light weight dressing and support sling on the effected shoulder, eating and drinking normally and taking only mild analgesia (pain killers).

Over the next 6 weeks patients will be expected to work on improving their new shoulder joints mobility and stability through a dedicated and progressive upper limb physiotherapy regime.

Your Consultant Surgeon will assess your joints stability and range of movement after 6 weeks and then again after three months to evaluate how successful your shoulder procedure has been. Patients should expect a continuous and full physical recovery to take around six to nine months to achieve.

Are there any risks associated with shoulder surgery?

Although shoulder surgery is regularly performed without any complications, it is very important that all candidates are fully aware of both the benefits and risks of undertaking this type of specialist upper limb surgery.

All surgery, no mater how expertly or carefully it is performed, carries risks and the importance of a full evaluation and consultation with an expert in shoulder surgery to discuss your condition in relation to these risks cannot be over emphasised.

How do I find out if I am a suitable candidate for shoulder surgery?

Surgical Advisor will be delighted to help you find a leading expert in shoulder surgery to consult with. Your surgeon will carry out a thorough evaluation of your condition and provide you with a comprehensive explanation of the most appropriate surgical solution.
 
Our Expert Consultant Orthopaedic Surgeons are most carefully selected and recommended because they understand the importance of the decision you are making when contemplating shoulder surgery and because of their specialist upper limb surgical expertise. Throughout your consultation you will therefore be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any recommended treatment.

To ensure that all patients are comfortable with any recommendations or advice given in their consultation, patients are asked to go away after a consultation and think through all the information they have received. If for whatever reason you are still not sure about the best course of action and wish to have further dialogue with your surgeon, you will not be expected to pay for a second consultation appointment.

How do I make a consultation appointment?

For further advice on how to make an appointment to consult with an expert upper limb orthopaedic surgeon: 

Please call Surgical Advisor on: 0870 41 41 41 2
Or email us by clicking on: advice@surgicaladvisor.com