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Does Your Frozen Shoulder Really Need Surgery?

Frozen shoulder is a painful condition and can cause you to struggle with basic shoulder movements, such as buckling a seatbelt or reaching above your head. Symptoms usually develop gradually and worsen as the shoulder loses mobility. Frozen shoulder happens when there’s inflammation or an injury to the shoulder capsule.

As a board-certified orthopedic surgeon, Dr. Matthew Pifer specializes in minimally invasive arthroscopic shoulder surgery.

Before considering surgery for a frozen shoulder, discussing non-surgical treatment options is wise. Frozen shoulder doesn’t always require surgery. In fact, in many cases, non-surgical approaches are effective. 

How frozen shoulder develops

Frozen shoulder usually develops gradually, starting as minor discomfort before escalating into pain and stiffness. 

During the "freezing" stage, the shoulder becomes increasingly painful, and the range of motion decreases. Pain is often worse at night, impacting sleep. The underlying cause is inflammation in the shoulder joint capsule, leading to fibrous adhesions and thickening of the capsule. 

The pain may decrease as the condition progresses to the "frozen" stage, but the shoulder becomes stiffer, severely limiting movement. 

The condition gradually improves in the "thawing" stage, and movement slowly returns. The entire process can take anywhere from 1-3 years. Risk factors for developing frozen shoulder include diabetes and prolonged immobilization of the shoulder due to surgery or injury.

Arthroscopic capsular release surgery for frozen shoulder 

When surgery is appropriate, Dr. Pifer performs arthroscopic capsular release surgery. This procedure involves inserting a small camera into the shoulder joint and using special tools to loosen the capsule surrounding the shoulder socket. That helps to restore flexibility to the joint. 

Typically, physical therapy begins immediately after surgery to prevent scar tissue.​​

Non-surgical treatments

Before considering surgery, non-surgical treatments are typically the first course of action. These include physical therapy, medications, and shoulder injections. 

Physical therapy, focusing on stretching and range-of-motion exercises, is a cornerstone of managing frozen shoulder. It stretches the shoulder for improved mobility. Pain relief and anti-inflammatory medications can also be beneficial in managing symptoms.

Corticosteroid shoulder injections are very effective at reducing inflammation and pain. In many cases, it is successful in managing frozen shoulder.

Patience is essential. Improvement occurs gradually, making it necessary to set realistic expectations. While non-surgical treatments can significantly alleviate pain and improve range of motion, they don't offer instant results. 

Making an Informed decision

Deciding whether to opt for surgery is a collaborative process. Consider factors like the severity of your symptoms, how much they interfere with your daily life, and your response to non-surgical treatments. 

Surgery is highly effective at treating frozen shoulder. However, a thorough evaluation is needed to determine the best approach. 

Surgery is often reserved for cases where conservative treatments have failed to restore shoulder mobility. If you’re dealing with frozen shoulder and non-surgical treatments haven’t helped, discuss it with Dr. Pifer. Contact us to schedule a consultation with Dr. Pifer today.

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