How is a frozen shoulder treated?

The natural course of a frozen shoulder can be separated into a few different phases. The first phase can be considered the "inflammatory" phase, during which the shoulder is painful and becomes less mobile. In the second phase, the shoulder is stiff, but the pain gradually decreases. In the third phase of "resolution", the motion gradually improves in the shoulder. The natural course of this disorder can be very long, and the goals of treatment are to speed you towards the "resolution" phase faster.

A supervised physical therapy program can be successful in helping improve the shoulder pain and limited motion of the frozen shoulder. Physical therapy is more often successful in people who suffer from "idiopathic" adhesive capsulitis, and it allows them to gain a lot more use and function from their shoulder. Unfortunately, this approach is less successful in the treatment of shoulder problems after a previous surgery or a bad injury.

Because there is some scientific evidence that inflammation of the shoulder joint is one of the causes of a frozen shoulder, many doctors will inject the shoulder joint in order to calm the inflammation down. This injection uses a long acting local anesthetic like the Xylocaine® that the dentist uses and a powerful anti-inflammatory steroid as well. This is a very safe procedure, it is not terribly painful, and sometimes a single shot can make a very significant difference in the amount of shoulder pain and motion. The reason that an injection is more effective than oral medications is that it allows doctors to deliver a higher concentration of a more powerful anti-inflammatory medication to the inflamed tissues. If these treatments prove to be unsuccessful after a period of several months, then there are several options. The first option after these measures have failed is for a doctor to perform manipulation under general anesthesia.

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