Frozen Shoulder Surgery

What is a Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is an inflammatory condition that affects the shoulder joint. It occurs when the connective tissue surrounding the shoulder joint, called the joint capsule, becomes inflamed and thickened. This causes pain, stiffness and a limited range of motion in the shoulder.

What are the Stages of Frozen Shoulder?

• Stage 1: Freezing - This stage involves the gradual onset of shoulder pain, which will be felt when reaching out for things and when you lie on the affected side at night. The pain worsens over time and can last anywhere between 2 to 9 months.

• Stage 2: Frozen - During this stage, shoulder pain is present but not as severe as the freezing stage. However, your shoulder may become increasingly stiff, making it difficult to perform work or recreational activities. This stage usually lasts 4-12 months.

• Stage 3: Thawing - In this final stage, the pain improves considerably and the shoulder movement is regained gradually. It typically takes from 6 months to 2 years.

How is Frozen Shoulder Diagnosed?

Diagnosing a frozen shoulder typically involves a combination of assessing your medical history, physical examination, and performing imaging tests such as X-rays, MRIs, and ultrasounds. The orthopaedic surgeon will check your range of movement and strength before assessing your shoulder's internal structure and formulating a diagnosis.

Who is at Risk of Developing a Frozen Shoulder?

Frozen shoulders more likely to develop in people with jobs that involve repetitive overhead activities or heavy lifting. Women are more likely to develop it compared to men, particularly so between the ages of 40 and 60. Certain medical conditions such as diabetes, thyroid disorders, and cardiovascular disease may also increase the risk of developing a frozen shoulder.

How is Frozen Shoulder Treated?

• Corticosteroid Injections

  These injections are administered directly into the affected shoulder, along with a local anaesthetic. It helps alleviate pain and reduce inflammation. However, it can only provide relief for a few weeks to a few months.

• Physiotherapy

  This involves working with a physiotherapist who will supervise and guide you through specific exercises and stretches to improve your shoulder’s range of motion, strength, and flexibility over time.

• Frozen Shoulder Surgery

  Surgical treatments for frozen shoulders are only considered when conservative methods have not proven successful. One common procedure is the arthroscopic capsular release, which involves removing the scarring and sometimes even parts of the inflamed joint capsule.

Preparing for Frozen Shoulder Surgery

You will have to adhere to preoperative instructions such as fasting before surgery, and avoiding certain medications and supplements temporarily. You should also arrange transportation to and from the hospital as the effects of anaesthesia and your wound will impair your ability to drive.

What Happens During Frozen Shoulder Surgery?

You will first be put to sleep via general anaesthesia. The surgeon then makes small incisions on the shoulder joint to insert the arthroscope and other specialised surgical instruments. This allows the surgeon to closely examine the inside of the shoulder joint.

The surgeon will then carefully release the thickened and tight joint capsule that is causing stiffness and limited movement. This creates more space for the shoulder to move freely. Thereafter, the incision will be closed up and you will be taken to the recovery room.

Recovering from Frozen Shoulder Surgery

Recovery can range between 6 weeks to 3 months. Your doctor will provide you with personalised post-surgery instructions to facilitate optimal healing. This may include:

• Resting the shoulder
• Keep the wound clean
• Taking medications as prescribed
• Adhering to physiotherapy exercises
• Lifestyle modification
• Attending follow-up check-ups with your doctor