Diligent physical therapy is often essential for recovery of many conditions but not for adhesive capsulitis frozen shoulder. There is no evidence that physiotherapy helps frozen shoulder at all. Physical therapy targeting frozen shoulder adhesive capsulitis will take months to years of treatment for recovery, depending on the severity of the scarring of the tissues around the shoulder. Over aggressive physical therapy has also been shown to significantly worsen the frozen shoulder as the body responds to additional trauma by over-reacting and laying down more scar tissue around the shoulder capsule. All forms of physical therapy for adhesive capsulitis frozen shoulder are basically useless, can often be torturous and have sometimes been known to significantly worsen the condition. Frozen shoulder sufferers have notoriously spent thousands of dollars and countless hours attending for treatments over months and years which do nothing to help and sometimes worsen the condition. We believe you will find yourself wasting your time and money attending for physical therapy sessions to alleviate your adhesive capsulitis frozen shoulder. Before you attend for physical therapy, be sure to ask the physiotherapist if they have ever had much success with frozen shoulder. The only cases, they may site as being successful, would most likely have improved of their own accord during the timeframe of treatment.
If non-surgical treatments do not ease symptoms or the shoulder joint is severely worn causing parts of the joint to become loose, a procedure called an arthroplasty may be recommended. This is a joint replacement treatment which involves replacing the ball with a synthetic ball and placing a cap for the scapula (known as a glenoid). After surgery passive shoulder exercises will be carried out and involve another person moving the joint. After 3-6 weeks patients are advised to start exercising the joint independently. Exercises and stretches are an important part of recovery and help to increase strength, flexibility and mobility in the joint. The success of surgery is dependent on the state of the rotator cuff muscles before surgery and the patient’s commitment to the exercise regime.
The most common outcome following non-operative management of adhesive capsulitis with a stretching program is decreased range of motion compared to the contralateral side.
Adhesive capsulitis is defined as painful loss of motion of a shoulder without an underlying cause. While it is generally believed to be a self-limiting condition, numerous treatment methods have been suggested including benign neglect, steroid injections, physical therapy, manipulation, and arthroscopic or open capsular releases. Intra-articular steroid injections may provide an earlier return of shoulder range of motion, but have not shown a long-term difference. Non-operative management with a stretching program shows high rates of patient satisfaction, but it is commonly associated with decreased range of motion compared to the contralateral extremity.
Griggs et al. reviewed 75 patients with phase-2 adhesive capsulitis who were treated non-operatively with a stretching program. At an average follow-up of 22 months, forward flexion increased by 19 degrees, but still remained 36 degrees less than the unaffected shoulder.
Shaffer et al. reviewed 62 patients with adhesive capsulitis who were treated non-operatively with a stretching program. At an average follow-up of 7 years, 60% of patients had decreased range of motion in at least one plane when compared to a control-group of normal shoulders.
Answer 1: While continued pain is a frequent complication, it is usually much improved from the initial onset of the disease and does not affect quality of life.
Answer 3: Adhesive capsulitis is thought to have a low recurrence rate after it has resolved.
Answer 4: Surgical intervention following non-surgical management of adhesive capsulitis is rare since > 90% report satisfaction with non-operative treatment.
Answer 5: The association between rotator cuff arthropathy and adhesive capsulitis has not been studied.