What is a Frozen shoulder?

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Frozen shoulder or adhesive capsulitis is a condition in which the shoulder joint becomes stiff and painful. The signs of the condition usually start slowly. They worsen over a period and subsequently resolve between one to three years.

The risk of frozen shoulder development heightens if the patient is recovering from a medical condition or procedure that does not allow them to move their arm, such as a mastectomy or stroke.

Frozen shoulder treatment involves range-of-motion exercises, and at times, the doctor will inject numbing meds and corticosteroids into the joint capsule. In a small number of cases, the patient may require arthroscopic surgery to make the joint capsule loose enabling it to move more freely.

It is not common for a frozen shoulder to occur again in the same shoulder. However, some patients may develop this condition in the opposite shoulder. Thomas & Bigler Knee & Shoulder Institute, led by board-certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada and surrounding locations in The Sagebrush State.

Stages of Frozen Shoulder

The shoulder capsule becomes thick, stiff, and tight in case of a frozen shoulder. Thick tissue bands, known as adhesions, develop. There is insufficient synovial fluid in the joint in many cases.

The main symptoms of a frozen shoulder are severe pain and the inability to move the shoulder, even with assistance. A frozen shoulder develops in the following three stages:

Stage 1: Freezing

The patient slowly experiences incremental pain in the “freezing stage.” The shoulder loses its range of movement as the pain level worsens. This stage usually lasts for six weeks to nine months.

Stage 2: Frozen

During this stage, the pain may actually reduce. However, the shoulder remains stiff. Routine activities may become insurmountable in the four to six months of the “frozen” stage.  

Stage 3: Thawing

In the “thawing” stage, the shoulder movement gradually gets better. It takes between six months to two years to return to the normal or close to normal range of motion and strength.

Treatment Options

This condition commonly improves over time. However, it may take up to three years to resolve. The goal of the treatment is pain control and the restoration of strength and motion by physical therapy.

Non-surgical Treatment

A majority of individuals with frozen shoulder respond to simple treatments, oral meds, and physical therapy to address the pain and restore movement.

Surgical Treatment

The doctor may discuss surgery with the patient if therapy and other conservative methods are unable to relieve their frozen shoulder symptoms. Notably, the patient should discuss their potential for recovering with continued conservative treatments, and the risks associated with a surgical procedure.

Frozen shoulder surgery is usually recommended in “Stage 2: Frozen.” The surgery aims to stretch and release the stiff joint capsule. Manipulation of the shoulder under anesthesia and shoulder arthroscopy are common techniques for treating this condition.

Manipulation under anesthesia

In this procedure, the patient is made to sleep. Subsequently, the doctor will force the patient’s shoulder to move. This will cause the scar tissue and capsule to stretch and tear. This helps release the tightening and improves the range of motion.

Shoulder Arthroscopy

In this surgical procedure, the doctor will slice tight parts of the joint capsule with pencil-sized instruments via tiny incisions placed on the shoulder. Experienced orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and nearby areas.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

A clavicle fracture (broken collarbone) also known as a fracture of the clavicle bone extends from the front part of the shoulder to the sternum (or breastbone) in the middle of the chest.

Thomas & Bigler Knee & Shoulder Institute, led by judicious board-certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada and surrounding locations in this region of the southwest.

Treatment for Clavicle Fracture

In case the patient suspects that they have a clavicle fracture, they must contact a doctor or seek medical help immediately. The doctor will order an x-ray to confirm the fracture.

The patient’s arm will be made immobile using a figure of eight bandages, collar, and cuff, or sling. The figure of eight bandage helps prevent shortening of the collarbone as it heals. This bandage is usually preferable to the sling.

The primary goal in the initial stages of the injury is pain relief. Therefore, the doctor typically prescribes pain meds for relief. Following a period of complete immobilization (one to two weeks), the patient’s arm should be delicately moved to prevent stiffness of the shoulder.

Shoulder flexion exercises to 90 degrees are particularly useful in preventing such stiffness. This involves moving the arm from its position on the side upwards horizontally.

The rehabilitation process will involve restoring the complete range of motion via mobility exercises and stretches and making sure that the strength is not impacted.

The injury may take four to six weeks to heal. The patient should not engage in any sports or even running until the injury has healed completely. However, the patient may still be able to undertake cycling on a stationary bike.

These types of fractures typically do not require surgery. Surgical intervention is more likely for open fractures (fractures where the bone goes through the skin) or if the bones do not fuse together after six weeks.

Surgical Treatment

Collarbone fracture surgery involves placing the broken fragments of the bone back in position and preventing them from moving out of place until the fracture has healed completely. This will enable the patient to improve strength in the shoulder once it heals.

A common surgery to treat collarbone fractures is the Open Reduction and Internal Fixation procedure. In this procedure, the surgeon will initially reposition or reduce the bone pieces into their natural alignment. After that, they will use special material hardware to hold the bone fragments in position. Some standard internal fixation techniques include the use of plates and screws.  

The surgeon will attach special screws and metal plates to the outer surface of the bone to hold the bone pieces in place after they are reduced into their natural position.

After the surgery, the patient may experience a small patch of numb skin beneath the incision. This will resolve over time. The patient may be able to detect the presence of the plate through the skin.

Even after the collarbone heals, the screws and plates are typically left in place. But if the patient is uncomfortable, these may be removed.

At times, surgeons use pins to hold the bone fragments together once the ends are put back in their normal position. Cordial orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and other towns and cities in this part of southeastern Nevada.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

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