OP – What is done?
If conservative treatment methods do not improve the symptoms of a frozen shoulder, surgery is performed. The shrunken joint capsule of the shoulder joint is either cut or selectively detached. The procedure is usually performed minimally invasively under general anesthesia in the form of arthroscopic shoulder surgery.A shoulder specialist first inserts a camera and corresponding instruments into the shoulder joint through two incisions of about 3 millimeters in size. He then removes the inflamed areas of the shoulder joint capsule under visual control and excises fibrous material from the shrunken joint capsule. If this is not sufficient, the joint capsule can also be cut or expanded to create the necessary space for surrounding structures.
Pain after surgery
Post-operative administration of painkillers is still prescribed after surgery on the shoulder joint capsule. This is because muscles, ligaments, tendons and connective tissue have to adapt to the new joint play in the shoulder joint. This process can take several weeks to months.
Due to its anatomy, the shoulder joint in particular is much more dependent on the surrounding musculature (especially the rotator cuff) than other joints, as this ensures the stability of the shoulder joint. However, the adaptation processes also affect the muscles around the shoulder blade (scapula), since the shoulder blade and the shoulder joint have a physiological interaction. Therefore, pain often occurs in the neck, the thoracic spine and around the shoulder blade.
Infections resulting from the surgical procedure can also cause pain. However, the rate of these cases is below 1% probability. In rare cases, post-operative capsulitis adhaesiva occurs, which leads to a temporary stiffening of the shoulder and thus prolongs the entire healing process, but usually heals without consequences.
Prognosis
Often the course of a frozen shoulder is very long, as no improvement can be expected without self-exercises, physiotherapeutic treatment and drug therapy. It is therefore particularly important that the affected patient actively and motivated over a longer period of time carries out a therapeutically accompanied rehabilitation program. Additional metabolic-activating therapy or hormonal treatment may also be necessary to prevent a recurrence of the frozen shoulder.
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