Definition

Adhesive capsulitis is a tightening in the shoulder joint. It decreases the range of motion in the shoulder and causes pain. This condition is also known as frozen shoulder. It is caused by tightening of the soft tissue and formation of scar tissue.

During closed manipulation, the doctor moves the arm at the shoulder joint. This is done to break up adhesions and loosen the stiff joint. The goal of the procedure is to improve range-of-motion by breaking up scar tissue.

Frozen Shoulder

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Reasons for Procedure

Your doctor may recommend closed manipulation if other methods of relief have failed. This procedure can relieve pain and stiffness for some people. In others, there is still some pain and swelling in the shoulder joint. If the closed manipulation is not successful, you may need arthroscopic surgery.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

    
  • Pain
  • Nerve injury
  • Damage to soft tissue
  • Instability or stiffness in joint
  • Fracture
  • Reaction to anesthesia used
  • Factors that may increase your risk of complications:

        
  • Smoking
  • Drinking
  • Chronic disease, such as diabetes or obesity
  • Prior shoulder surgery
  • What to Expect

    Prior to Procedure

    Your doctor may do the following:

        
  • Physical exam
  • Blood and urine tests
  • X-ray
  • MRI scan
  • Leading up to the procedure:

        
  • Arrange for a ride to and from the hospital, and for help at home after the procedure.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.
  • Anesthesia

    Your doctor may choose either:

        
  • General anesthesia —You will be asleep during the surgery.
  • Local anesthesia (less common)—The shoulder area will be numbed.
  • Description of the Procedure

    The doctor will twist and move your shoulder upward and outward. The actions will break up scar tissue to improve range of motion.

    Immediately After Procedure

    If you had general anesthesia, you will be taken to a recovery room and monitored.

    How Long Will It Take?

    45-60 minutes

    How Much Will It Hurt?

    Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

    Average Hospital Stay

    Once you recover from the anesthesia, you will be able to go home.

    Post-procedure Care

    During your stay, the hospital staff will take steps to reduce your chance of infection such as:

        
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
  • There are also steps you can take to reduce your chances of infection such as:

        
  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
  • You will have pain and swelling for 1-2 weeks after the surgery. Your doctor may instruct you to begin physical therapy.

    Call Your Doctor

    It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

        
  • Cough, trouble breathing, or chest pain
  • Severe nausea or vomiting
  • Pain becomes worse or swelling increases
  • Tingling or numbness that will not go away, especially in arms and hands
  • If you think you have an emergency, call for medical help right away.