Frozen shoulder generally is usually self-limiting, and gets better over time, although it may take anywhere from 6 months to 4 years.
The goal of treatment is to control pain and restore motion and strength.
Majority of patients improve with relatively simple treatments to control pain and restore motion.
Non-steroidal anti-inflammatory medicines. Drugs like ibuprofen, aceclofenac and paracetamol reduce pain and inflammation.
Physiotherapy. Specific exercises will help restore motion. These are usually done under the supervision of a physiotherapist initially, and later on via a home program. Therapy includes stretching or range of motion exercises for the shoulder. Sometimes heat is used to help loosen the shoulder up before the stretching exercises.
Ultrasound guided steroid injections and Hydrodistention. Occasionally, your doctor might suggest injections into the shoulder joint to control the pain when it is severe. Steroid and local anaesthetic is injected directly into your shoulder joint. Ultrasound guidance helps accurate positioning of the needle into the joint, where it will act on the inflamed capsule. Ultrasound guidance also helps in assessment of the soft tissues covering your shoulder, and rules out tears of the rotator cuff or impingement.
If your symptoms are not relieved by therapy, medicines and injections, you and your shoulder surgeon may discuss surgery. It is important to talk with your surgeon about your potential for recovery continuing with simple treatments, and the benefits and risks involved with surgery.
The goal of surgery for frozen shoulder is to release and stretch the stiffened joint capsule.
Manipulation under anesthesia. This is a historical procedure, but is not in favour nowadays. It could potentially end up damaging important tendons and cartilage.
Shoulder arthroscopy and capsular release. In this procedure, your hand will be made numb by anaesthesia. Then your surgeon will release the tight portions of the joint capsule through key-hole surgery. This is done using pencil-sized instruments inserted through small cuts around your shoulder. Most patients have good outcomes with these procedures.
Recovery. After surgery, physiotherapy is necessary to maintain the motion that was achieved with surgery. Recovery times vary, from 6 weeks to three months. Although it is a slow process, your commitment to therapy is the most important factor in returning to all the activities you enjoy.
Long-term outcomes after surgery are generally good, with most patients having reduced or no pain and improved range of motion. In some cases, however, even after several years, the motion does not return completely and a small amount of stiffness remains.
Although uncommon, frozen shoulder can recur, especially if a contributing factor like diabetes is still present.