Adhesive Capsulitis—Closed Manipulation
(Frozen Shoulder—Closed Manipulation)
Definition
Adhesive capsulitis (frozen shoulder) is a tightening of the tissue around the shoulder joint. It makes it hard to move the shoulder. Closed manipulation improves range of motion by moving the arm at the shoulder to break up scar tissue.
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Reasons for Procedure
This procedure is done to:
- Ease pain and stiffness
- Improve range of motion in the shoulder
- Break up scar tissue
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Problems from anesthesia, such as wheezing or sore throat
- Nerve injury
- Damage to soft tissue
- Instability or stiffness in joint
- Fracture
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The care team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
- Fasting before the procedure, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from the procedure
- Tests that will need to be done before the procedure, such as images
Anesthesia
The doctor may give:
- General anesthesia—you will be asleep
- Local anesthesia—the area will be numbed (less common)
Description of the Procedure
The doctor will twist and move the shoulder upward and outward. The actions will break up scar tissue to improve range of motion.
How Long Will It Take?
45 to 60 minutes
Will It Hurt?
Pain and swelling are common in the first two weeks. Medicine and home care can help.
Average Hospital Stay
Most people leave the same day. If you have any problems, you may need to stay longer.
Post-procedure Care
Right after the procedure, the staff may:
- Give you pain medicine
- Raise the shoulder to ease swelling
- Apply ice to the area
- Put your arm in a sling to support the shoulder
Physical therapy will be started soon after the procedure.
At Home
It may take 3 months to heal. Physical activity will be limited during recovery. You may need to ask for help with daily activities and delay return to work.
Call Your Doctor
Call the doctor if you are not getting better or you have:
- Cough, shortness of breath, or chest pain
- Nausea or vomiting
- Pain that you cannot control with medicine
- Tingling or numbness that will not go away, especially in the arms and hands
If you think you have an emergency, call for medical help right away.
RESOURCES:
Ortho Info— American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org
Sports Med—American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org
CANADIAN RESOURCES:
Canadian Orthopaedic Association
http://www.coa-aco.org
Canadian Orthopaedic Foundation
http://www.canorth.org
REFERENCES:
Adhesive capsulitis of shoulder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/adhesive-capsulitis-of-shoulder. Accessed September 29, 2020.
Frozen shoulder. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00071. Accessed September 29, 2020.
Le HV, Lee SJ, et al. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow. 2017 Apr;9(2):75-84.
Shoulder arthroscopy. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00589. Accessed September 29, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM Last Updated: 6/8/2021