Adhesive Capsulitis—Closed Manipulation Overview

Adhesive capsulitis is a tightening in the shoulder joint. It decreases the range of motion in the shoulder and causes pain. The shoulder does not have full range of motion even when a therapist tries to move the shoulder. This condition is also known as frozen shoulder . It is caused by tightening of the soft tissue and formation of scar tissue.

During closed manipulation, the doctor moves the arm at the shoulder joint. This is done to break up adhesions and loosen the stiff joint. The goal of the procedure is to improve range-of-motion by breaking up scar tissue.

Frozen Shoulder © 2009 Nucleus Medical Media, Inc.

Prior to Procedure

Your doctor may do the following:

• Physical exam
• Blood and urine tests
• X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones
• MRI scan —a test that uses magnetic waves to make pictures of structures inside the body

Leading up to the procedure:

• Arrange for a ride to and from the hospital. Also arrange for help at home after the procedure.
• The night before, eat a light meal. Do not eat or drink anything after midnight. If you have diabetes, you may need to adjust your medicines. Ask your doctor about this.

Anesthesia

Your doctor may choose either:

• General anesthesia —You will be asleep during the surgery.

• Local anesthesia (less common)—The shoulder area will be numbed.

Description of the Procedure

The doctor will twist and move your shoulder upward and outward. The actions will break up scar tissue to improve range of motion.

Immediately After Procedure

If you had general anesthesia, the nurses will monitor you in the recovery room.

How Long Will It Take?

45-60 minutes

How Much Will It Hurt?

You will feel no pain during the procedure. You will have soreness after the procedure. The doctor will give you pain medicine.

Average Hospital Stay

Once you recover from the anesthesia, you will be able to go home.

Post-procedure Care

You will have pain and swelling for 1-2 weeks after the surgery. Your doctor may instruct you to:

• Ice the swollen area for the first 24-48 hours. Do this for periods of 20-30 minutes.
• Sleep sitting up or in a recliner. Place a pillow behind your elbow.
• Periodically open and close your hand and move your elbow.
• Begin intense physical therapy.
• Be sure to follow your doctor’s instructions .

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org/

American Orthopaedic Society for Sports Medicine
http://www.aossm.org/

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/

Canadian Orthopaedic Foundation
http://www.canorth.org/

References:

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