Effective Treatments for Frozen Shoulder: What Works Best?

Q: Effective Treatments for Frozen Shoulder: What Works Best?

Hello： Thank you for your inquiry. <br>Here are my responses and recommendations： <br>1. <br>For the treatment of frozen shoulder (adhesive capsulitis), deep heat therapy (such as shortwave diathermy, ultrasound, and laser therapy) and electrical therapy (such as interferential c

The most appropriate treatment method for frozen shoulder (adhesive capsulitis) is physical therapy?

I have shoulder pain and have received treatment at a hospital in the northern region, including electrical therapy and painful stretching.
What type of treatment would be more effective?

Apo, 50~59 year old female. Ask Date: 2007/07/22

Dr. Chen Xianchang reply Rehabilitation

Hello: Thank you for your inquiry.
Here are my responses and recommendations:
1.
For the treatment of frozen shoulder (adhesive capsulitis), deep heat therapy (such as shortwave diathermy, ultrasound, and laser therapy) and electrical therapy (such as interferential current and SSP) should be administered.
Additionally, appropriate exercises (such as pendulum exercises, shoulder circles, and finger ladder exercises) should be taught.
Finally, joint mobilization techniques should be performed, adhering to the principle of avoiding pain or only experiencing mild discomfort.
If significant pain occurs, it indicates that the range of motion has exceeded appropriate limits.
2.
The aforementioned treatments are all essential.
If the range of motion remains insufficient, consideration may be given to local injections and shockwave therapy.

Reply Date: 2007/07/22

More Info

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. It typically progresses through three stages: the freezing stage, the frozen stage, and the thawing stage. Each stage can last for several months, and the condition can significantly impact daily activities and quality of life. Given your experience with electrotherapy and painful stretching, it’s essential to explore a comprehensive treatment approach that may include physical therapy, medication, and possibly more invasive options if conservative treatments fail.

Effective Treatments for Frozen Shoulder
1. Physical Therapy: This is often the cornerstone of treatment for frozen shoulder. A physical therapist can design a tailored exercise program that focuses on improving range of motion and reducing pain. Techniques may include:
- Stretching Exercises: Gentle stretching can help improve flexibility and reduce stiffness. It's crucial to perform these exercises consistently, as they can help prevent the shoulder from becoming more rigid.

- Strengthening Exercises: Once the pain decreases and range of motion improves, strengthening exercises can help stabilize the shoulder joint.

2. Medications: Over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation. In some cases, your doctor may prescribe corticosteroids to reduce inflammation and pain.

3. Injections: Corticosteroid injections directly into the shoulder joint can provide significant relief from pain and inflammation. This can be particularly effective during the freezing stage when pain is most severe. However, as you may have concerns about the long-term use of steroids, it’s essential to discuss the risks and benefits with your healthcare provider.

4. Hydrodilatation: This procedure involves injecting a sterile solution into the shoulder joint to expand the capsule and help break up adhesions. It can be performed under imaging guidance and may provide immediate relief and improved range of motion.

5. Surgery: If conservative treatments fail after several months, surgical options may be considered. This can include:
- Arthroscopic Capsular Release: This minimally invasive procedure involves cutting the tight portions of the shoulder capsule to relieve tension and improve mobility.

- Manipulation Under Anesthesia: In this procedure, the doctor manipulates the shoulder while the patient is under anesthesia to help break up adhesions.

6. Alternative Therapies: Some patients find relief through acupuncture, massage therapy, or chiropractic care. While these treatments may not be supported by extensive scientific evidence, they can provide symptomatic relief for some individuals.

Conclusion
The effectiveness of treatment for frozen shoulder can vary from person to person. It’s crucial to work closely with your healthcare provider to develop a comprehensive treatment plan tailored to your specific needs and circumstances. Regular follow-up appointments can help monitor your progress and adjust your treatment plan as necessary.
In summary, a combination of physical therapy, medication, and possibly injections or surgical options may provide the best outcomes for managing frozen shoulder. Be sure to communicate openly with your healthcare team about your symptoms, treatment preferences, and any concerns you may have regarding specific therapies. With appropriate management, many individuals experience significant improvement in their shoulder function and pain levels over time.

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