Firstly is can be very difficult to diagnose a frozen shoulder.
IF it is a TRUE frozen shoulder, for many patients whose symptoms are tolerable, a wait and see approach is quite reasonable. Typically if symptoms are tolerable at the 6 months following onset, no intervention will be required.
Physiotherapy may exacerbate the pain in the first few months following the onset of symptoms in what we call the freezing phase or the inflammatory phase of this condition. Nevertheless in the thawing phase when the inflammation has settled, physiotherapy and stretch exercises might accelerate recovery in range of motion.
Cortisone injections reduce inflammation. For it to be effective in frozen shoulders the injection has to be performed into the glenohumeral joint, not the bursa. They can provide 3-4 weeks of symptomatic relief. As this condition is only temporary and usually at its worse for a short period, this treatment is quite effective and usually only 1 or 2 injections are required to alleviate the worse of the symptoms.
If the symptoms do not respond well to cortisone injections and are prolonged or intolerable, an arthroscopic capsular release is a key-hole day-surgery operation in which the inflamed and thickened capsule can be released. This allows often dramatic relief in the severe pain and accelerates recovery in the range of motion.
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