We aren’t exactly sure what causes a frozen shoulder (adhesive capsulitis) but we do know that it results in scar adhesions in the shoulder joint capsule reducing the ability of the arm to rotate in the shoulder socket.
In my experience, most of these frozen shoulders started with the onset of shoulder pain which made the patient not want to move their shoulder. This, coupled with the inflammation associated with the cause of the pain, results in these adhesions forming around the joint capsule.
A tell-tale sign of a frozen shoulder is that both active and passive range of motion are both equally decreased. This is fairly easily evaluated during the physical exam.
How do you treat adhesive capsulitis (frozen shoulder)?
There are 2 primary targets for treating adhesive capsulitis:
- Increase range of motion
- Reduce pain
There are a number of therapies commonly used to help with both of these. Physical therapy can be helpful for increasing range of motion. Anti-inflammatory medications (NSAIDs) are often prescribed. Some patients may get steroid injections which may be beneficial in some cases. Massage therapy and daily stretching techniques may help.
I don’t recommend steroid injections for musculoskeletal issues. Steroids are damaging to the tissues and make them weaker. I recommend avoiding steroids at all costs for these kinds of issues.
These adhesions can be broken under sedation in the operating room if they don’t improve. For really bad cases surgery could be considered to break down these adhesions.
I don’t recommend surgery very often. There are just too many risks most of the time. However, surgery certainly has its place and can be fabulous. It just needs to be used appropriately.
Prolotherapy for frozen shoulder?
There is another therapy that has been shown to be very beneficial but not well know. Prolotherapy can be a tremendous benefit for frozen shoulders.
While prolotherapy by itself won’t increase the range of motion it can have a dramatic and profound impact on the pain which can allow increased efforts on stretching and mobilization techniques.
We have treated numerous patients with adhesive capsulitis and prolotherapy has provided them exceptional benefit. Prolotherapy is my first recommendation for nearly all causes of shoulder pain but certainly with frozen shoulders.
There is next to no risk associated with prolotherapy. It is extremely cost effective and often very successful.
If you have a frozen shoulder then you should consider prolotherapy as it can melt away this painful condition.
Call our clinic today to schedule your evaluation.