Shoulder manipulation is a procedure where the arm is forcibly stretched in various positions to relieve stiffness and pain caused by frozen shoulder. In some cases, the manipulation may cause tearing in the shoulder joint. Motion is restored, but as the body begins to repair the area it lays down more scar tissue which can potentially cause more loss of motion and pain. This means the patient must undergo additional physical therapy to prevent further loss of motion.
Understanding the procedure
In most cases, there is no actual surgery involved, meaning incisions (cuts) are not made when a manipulation is performed. After anesthesia is given, the surgeon will move the shoulder through a full range of motion in order to break up scar tissue to improve shoulder mobility.
The alternative to manipulation is arthroscopic release. It is usually performed on people who have a severe loss of mobility in the shoulder. After anesthesia is given, the surgeon inserts a small camera and other instruments through very small incisions in the shoulder. This allows the surgeon to see inside the shoulder and to remove any scar tissue surrounding the joint. A gentle manipulation follows. This will significantly reduce the risk of injury if the frozen shoulder has been present for some time. If necessary, other disorders within the shoulder can be addressed at the same time.
Indications for the procedure
Surgery is usually recommended when more conservative methods, such as physical therapy or anti-inflammatory medications, fail to relieve pain and restore range of motion.