Frozen shoulder

(Part 2)

How is frozen shoulder diagnosed?

To diagnose frozen shoulder (adhesive capsulitis), your healthcare provider will discuss your symptoms and review your medical history. 

They’ll also perform a physical exam of your arms and shoulders. They will:

  • Move your shoulder in all directions to check your range of motion and if there’s pain with movement. This type of exam, in which your provider moves your arm, is called determining your “passive range of motion.”
  • Watch you move your shoulder to see your “active range of motion.”
  • Compare the two types of motion. People with frozen shoulder have a limited range of both active and passive motion.

Your provider will likely order shoulder X-rays to make sure the cause of your symptoms isn’t due to another problem with your shoulder, like arthritis. 

You usually don’t need advanced imaging tests like magnetic resonance imaging (MRI) and ultrasound to diagnose frozen shoulder. But your provider may request them to look for other problems, like a rotator cuff tear.

Management and Treatment – What treatment is best for frozen shoulder?

Frozen shoulder treatment usually involves pain relief methods until the initial phase passes. You may need therapy or surgery to regain motion if it doesn’t return on its own.

Some simple adhesive capsulitis treatments include:

* Hot and cold compresses. These help reduce pain and swelling.

* Medicines that reduce pain and swelling. These include nonsteroidal anti- inflammatory drugs (NSAIDs). Your healthcare provider may prescribe other painkiller/anti-inflammatory drugs. You can manage more severe pain and swelling with steroid injections. Your provider will inject a corticosteroid, like cortisone, directly into your shoulder joint.

* Physical therapy. A physical therapist can teach you stretching and range-of-motion exercises.

* Home exercise program. Your healthcare provider can show you exercises you can do at home.

* Transcutaneous electrical nerve stimulation (TENS). Use of a small, battery- operated device that reduces pain by blocking nerve impulses.

If these noninvasive treatments haven’t relieved your pain and shoulder stiffness after about a year, your provider may recommend referral to an Orthopedic Surgeon for other procedures. 

These include:

 ∙    Manipulation under anesthesia: During this surgery, you’ll be put to sleep, and your provider will force movement of your shoulder. This will cause your joint capsule to stretch or tear to loosen the tightness. This will lead to an increase in your range of motion.

  • Shoulder arthroscopy: Your provider will cut through the tight parts of your joint capsule (capsular release). They’ll insert small, pencil-size instruments through small cuts (incisions) around your shoulder.

Providers often use these two procedures together to get better results.