Should You Consider Minimally Invasive Surgery for Shoulder Adhesions?

Is minimally invasive surgery necessary for shoulder muscle adhesion?

Six months ago, I had an accident abroad where I fell in the bathroom and landed on my right hand.
Since then, I have been experiencing severe pain in my right shoulder and arm.
Two months after the fall, the pain in my shoulder and arm became so intense that I was unable to move them, and I also had discomfort in my back.
Recently, over the past two months, my entire arm has been numb and sore to the point where I can't sleep.
I consulted an orthopedic specialist, and X-rays and ultrasounds showed that my bones and ligaments are normal, but there is evidence of muscle adhesion in my shoulder.
I have tried treatments such as acupuncture, physical myofascial therapy, and traditional Chinese massage, but these have only provided temporary relief without significant progress.
I can raise my arm slightly and move it up and down, but the pain persists.
Do you think I need minimally invasive surgery? Thank you.

Ni Ke, 40~49 year old female. Ask Date: 2020/05/09

Dr. Shi Guozheng reply Orthopedics

Surgery is usually not necessary for your symptoms, which may be adhesive capsulitis of the shoulder joint.
Treatment options include physical therapy or corticosteroid injections into the joint.
Recovery typically takes about six months to a year.
Clinical reports also indicate that if left untreated, it may gradually improve over a year and a half, although the range of motion in the shoulder may only reach 80 to 90% of normal.
This condition commonly occurs around the age of 50, but it can also affect individuals in their 40s.

Reply Date: 2020/05/09

More Info

When considering whether to undergo minimally invasive surgery for shoulder adhesions, it's crucial to evaluate your specific condition, the severity of your symptoms, and the effectiveness of conservative treatments you've already tried. Based on your description, it seems that you have been experiencing significant pain and limited mobility in your shoulder and arm following an accident six months ago. Despite various treatments, including acupuncture, physical therapy, and traditional Chinese medicine, you have not seen substantial improvement.

Shoulder adhesions, often referred to as adhesive capsulitis or "frozen shoulder," can occur after an injury or surgery, leading to stiffness and pain. In your case, the pain and limited range of motion in your shoulder could be attributed to the formation of scar tissue around the shoulder joint, which restricts movement. This condition can be particularly frustrating, especially when it interferes with daily activities and sleep.

Minimally invasive surgery, such as arthroscopic release of adhesions, can be an effective treatment option for individuals who have not responded to conservative measures. This type of surgery involves making small incisions and using a camera and specialized instruments to remove the adhesions and restore mobility to the shoulder joint. The advantages of minimally invasive surgery include reduced recovery time, less postoperative pain, and a lower risk of complications compared to traditional open surgery.

Before deciding on surgery, it is essential to consider the following factors:
1. Duration of Symptoms: Since your symptoms have persisted for six months without significant improvement, this may indicate that conservative treatments are unlikely to provide the relief you need.

2. Impact on Daily Life: If your shoulder pain and limited mobility are significantly affecting your quality of life, work, or daily activities, surgery may be a more appropriate option.

3. Response to Conservative Treatments: You mentioned trying various treatments without substantial progress. If you have exhausted these options and still experience debilitating symptoms, it may be time to consider surgical intervention.

4. Consultation with a Specialist: It is crucial to consult with an orthopedic surgeon who specializes in shoulder conditions. They can perform a thorough evaluation, including imaging studies, to assess the extent of the adhesions and determine if surgery is warranted.

5. Rehabilitation Post-Surgery: If you opt for surgery, be prepared for a rehabilitation process afterward. Physical therapy will be essential to regain strength and mobility in your shoulder.

In summary, if conservative treatments have not alleviated your symptoms and your quality of life is being affected, minimally invasive surgery could be a viable option to consider. It is essential to have a detailed discussion with your orthopedic surgeon about the potential benefits and risks associated with the procedure, as well as what you can expect during the recovery process. Ultimately, the decision should be based on a comprehensive assessment of your condition and personal preferences.

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