Frozen Shoulder Treatment Options

The exact cause of frozen shoulder is not always clear, but it often follows a period of shoulder immobilization due to injury, surgery, or illness. It is more common in individuals between ages 40 and 60 and is seen more frequently in women than men. Conditions such as diabetes, thyroid disorders, and cardiovascular disease can increase the risk.

Frozen shoulder typically progresses through three stages: the freezing stage, the frozen stage, and the thawing stage. During the freezing stage, shoulder pain gradually worsens, and movement becomes increasingly restricted. The frozen stage is characterized by persistent stiffness, while pain may decrease. Finally, in the thawing stage, range of motion slowly begins to return. This entire process can take months to years if left untreated. In most cases, frozen shoulder can be managed successfully without surgery.

The goal of conservative treatment is to relieve pain, reduce inflammation, and restore mobility through targeted therapies and medications.

• Physical therapy – Physical therapy is the cornerstone of frozen shoulder treatment. At Ortho Illinois, our rehabilitation specialists create personalized exercise programs to improve shoulder flexibility and strength. Early in the process, gentle range-of-motion exercises are introduced to prevent further stiffness. As mobility improves, more advanced stretching and strengthening exercises are added to restore full function. Consistent therapy can significantly shorten the duration of symptoms and prevent recurrence.
• Medications – Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are often recommended to manage pain and reduce inflammation. For individuals with more severe discomfort, oral corticosteroids may be prescribed for a short duration to alleviate pain and improve mobility.
• Corticosteroid injections – A corticosteroid injection directly into the shoulder joint can provide rapid pain relief and reduce inflammation within the capsule. This treatment is often used early in the freezing stage to facilitate participation in physical therapy. The effects can last for several weeks to months and help patients achieve greater progress in their rehabilitation.
• Hydrodilatation – Hydrodilatation, also known as joint distension, involves injecting a sterile saline solution into the shoulder joint to stretch and expand the capsule. This minimally invasive procedure can help break up adhesions, improve mobility, and reduce pain. It is typically performed under ultrasound guidance to ensure accuracy and safety.
• Heat and cold therapy – Applying heat before stretching can relax the shoulder muscles and make movement easier, while ice packs after activity can help control pain and inflammation. These simple measures can be used at home to complement formal therapy sessions.
• Activity modification – During recovery, it is important to avoid activities that strain the shoulder joint. Patients are encouraged to maintain a balance between rest and gentle motion, keeping the shoulder as active as possible without causing sharp pain.

When conservative methods fail to relieve symptoms after several months, surgical intervention may be recommended. The orthopedic surgeons at Ortho Illinois are experienced in advanced minimally invasive procedures designed to restore motion and relieve pain.

• Arthroscopic capsular release – Arthroscopic capsular release is the most common surgical treatment for frozen shoulder. Using a small camera and specialized instruments inserted through tiny incisions, the surgeon carefully releases the thickened joint capsule and removes scar tissue. This procedure allows immediate improvement in shoulder motion and is followed by an intensive rehabilitation program to maintain flexibility.
• Manipulation under anesthesia – In some cases, the surgeon may perform manipulation under anesthesia, where the shoulder is gently moved through a range of motion while the patient is asleep. This helps break up adhesions and restore flexibility. It is often combined with arthroscopic release for optimal results.

Following surgery, early and consistent physical therapy is essential. The rehabilitation team at Ortho Illinois works closely with each patient to develop a customized recovery plan that focuses on restoring full motion, preventing stiffness, and strengthening the shoulder muscles. Most patients can expect gradual improvement in pain and mobility over several weeks to months.

With appropriate treatment, most patients with frozen shoulder recover normal or near-normal shoulder function. Early diagnosis and intervention can prevent the condition from worsening and reduce overall recovery time. While frozen shoulder can be frustrating, a structured treatment plan that combines medical care, physical therapy, and patient commitment can lead to excellent outcomes.