The first line treatment for adhesive capsulitis, also known as frozen shoulder, is a combination of physical therapy and medications. Physical therapy is typically the first step in treatment and should begin within the first few weeks of the onset of symptoms. Physical therapy focuses on restoring range of motion, improving shoulder strength, increasing flexibility and decreasing pain. Therapeutic exercises are used to target the areas of stiffness and pain. Strengthening exercises, stretching, and other forms of manual therapy are also used to improve shoulder function.
Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), are often prescribed to help reduce pain and inflammation. Oral steroids may also be prescribed to reduce the inflammation and pain associated with adhesive capsulitis. Corticosteroid injections into the shoulder joint may be recommended to help reduce inflammation and provide short-term relief of pain. In some cases, joint manipulation or manipulation under anesthesia may be recommended to help reduce pain and improve range of motion.
When conservative treatments are ineffective, surgical intervention may be recommended. Surgery for adhesive capsulitis typically involves manipulating the shoulder joint and releasing the adhesions in the joint capsule. This procedure may be recommended in cases of severe adhesive capsulitis where conservative treatments have failed.
Adhesive capsulitis is a condition that can take several months to a year to fully resolve. With the right combination of physical therapy, medications, and in some cases, surgery, most individuals with adhesive capsulitis can eventually regain full range of motion and improve shoulder strength and function.