Stiff Shoulder also known as frozen shoulder or adhesive capsulitis is a complex condition which is less understood all over the world. In my practise we prefer to treat most of the patients with stiff shoulder with our excellent rehab programme. Patients typically attend our unique exercise program & are supervised for two weeks back to back. They are assessed for improvement in range of movement, pain relief & strength gain at the end of 2 weeks. If they are 50% better, they qualify to do n a home program for the next 6-8 weeks. Almost more that 85% patients improve with this regime. The program is a novel & unique combination of Theraband exercises &range of movement restoration. We prefer not to prescribe pain killers or mechanical modalities like Ultrasound or short wave diathermy or IFT. The idea is to initiate an improvement which the patient can then sustain by practising at home.
Patients that come late or with severe grade III stiffness may respond sub optimally to the rehab program & may need surgery for the same. We perform this rarely. No patients offered surgery for this condition unless he has done a trial of rehab before. In such patients we perform arthroscopic adhesiolysis. This involves key-hole surgery where we release the tight adhesions which are cord like stiff bands which are responsible for constraining the movements of the shoulder joint. This involves resecting the CHL ligament, anterior & posterior capsule, subacromial decompression along with a Suprascapular nerve decompression. Patients are given a nerve block for pain relief which last for about 10-12 hours. Some patients may also need a Fentanyl skin patch for pain relief & this usually lasts for 4-5 days. Patients are discharged the very next day after surgery. Ten days after surgery the sutures are removed and patients start their physiotherapy rehab movement right away. The success of this surgery depends a lot on success & compliance of the patient to the immediate rehab program. Patients typically regain their full function in 2-3 months time depending on how late they present for treatment.