Stiffness in the shoulder can be the result of the diagnoses described above, such as impingement syndrome, calcific tendinitis, shoulder instability, or rotator cuff rupture.
Most frequently, however, “frozen shoulder” appears as an independent diagnosis. The cause has been attributed to endogenous factors like hormonal changes (menopause) or ailments like diabetes and thyroid disease. The capsule progressively shrinks, with increasing and usually very painful limitation on movement. In all cases long-term conservative treatment (physical therapy, medications) should be tried extensively. If this treatment should turn out to be unsuccessful, the shoulder can be operated on.
The joint is gently stretched under arthroscopy. In particularly recalcitrant cases, the capsule can be split and a partial removal of the joint membrane (synovectomy) may be necessary.
Rehabilitation after shoulder operations is estimated to take about 3 to 4 months. Post-operative treatment calls for early functioning, without a long period of immobilization of the arm. As early as the day of the operation, we begin with gentle mobilization in order to avoid clumping in the joint. The patient must carry out the post-operative treatment in a disciplined fashion in order to achieve good functional results and freedom from pain. In some cases, we also use a motorized splint for passive movement of the shoulder. Taking medications to reduce inflammation is often necessary.