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Manipulation under anesthesia...

In the process of a manipulation under anesthesia the patient is brought into the operating room and given a general anesthetic by an anesthesiologist. With the patient asleep and with their muscles paralyzed, the shoulder is then taken through a "range of motion". In the course of manipulating the shoulder to reach a nearly full range of motion, popping sounds can often be heard inside the joint, signifying a tearing of the adhesions. At the same time, it is possible to gradually stretch the muscles that are external to the shoulder joint.

When a patient wakes up from this procedure, their shoulder is often a bit more painful than it was before the procedure. A special effort is made to control shoulder pain after a manipulation under anesthesia with narcotic pain medications so that the patient is able to move their shoulder without fear of disabling pain. The most important part of this process actually comes after the manipulation, because physical therapy is used to insure that the improvements in motion are not lost by inactivity. Therefore, it is very important that patients who have had a manipulation under anesthesia have easy access to physical therapy and are motivated to complete their home exercise.

What happens if this doesn't work?

Usually, a manipulation under anesthesia followed by physical therapy is successful in the majority of patients. However, if it is unsuccessful, a surgical procedure can be performed certain situations in which an arthroscope is placed in the shoulder and the adhesions and scar tissue are removed.

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