FROZEN SHOULDER TREATMENT
MELBOURNE

Frozen Shoulder Treatment Melbourne

A Patient’s Guide:

 Dr Christopher Pullen – BSc(Hons), MBBS, MPH, FRACS, FAorthoA.
Orthopaedic Surgeon

“I may recommend a surgical approach if you have a painful condition that does not respond to nonsurgical treatment including rest, physical therapy, medications and injections.

Prior to recommending surgery, I will undertake a thorough clinical examination, discuss your diagnosis and detail the treatment options to ensure you understand the benefits and potential complications.”

PATIENT CARE PROCESS – DR CHRISTOPHER PULLEN
Dr Pullen’s approach to your care:

1. First Appointment

Referral, consultation & testing.

2. Diagnosis

Diagnosis & treatment options.

3. Treatment Plan

Non-operative VS operative.

4. Follow up & care plan

Monitoring, pain relief & care plan.

SHOULDER JOINT ANATOMY

What are the joints, muscles and ligaments in your shoulder?

The shoulder is made up of three bones:

(1) The Scapula (shoulder blade), (2) Clavicle (collarbone) and; (3) Humerus (upper arm bone)

The shoulder joint is formed where the humerus (upper arm bone) fits into the scapula (shoulder blade), like a ball and socket.

Other important shoulder bones include:

The acromion – The bony projection off the scapula.
The clavicle (collarbone) – This meets the acromion in the acromioclavicular joint.
The coracoid process – The hook-like bony projection from the scapula.

The shoulder has several other important structures including:

The bursa – A small sac of fluid that cushions and protects the tendons of the rotator cuff.
The rotator cuff – A collection of muscles and tendons that surround the shoulder, giving it support and allowing a wide range of motion.
The labrum – A cuff of cartilage that forms a lip for the ball-like head of the humerus to fit into the socket.

The humerus fits relatively loosely into the shoulder joint, allowing the shoulder a wide range of motion.

Shoulder Anatomy

Figure 1

WHAT IS FROZEN SHOULDER

Frozen shoulder, (also called adhesive capsulitis) involves stiffness, pain and limited range of motion in the shoulder joint.

The shoulder joint is enclosed in a capsule of connective tissue.

Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, thick bands of tissue (called adhesions) develop, restricting the shoulders movement.

In many cases, there is less synovial (lubricating) fluid in the joint.

It’s more likely to happen after keeping a shoulder still for a long period, such as after surgery or an arm fracture.

Frozen shoulder typically develops slowly over 2 to 4 months and may progress as follows:

1. Freezing stage – Any movement of the shoulder causes pain, and the shoulder’s ability to move becomes limited. This stage lasts from 2 to 9 months.

2. Frozen stage – Pain might lessen during this stage. However, the shoulder becomes stiffer. Using it becomes more difficult. This stage lasts from 4 to 12 months.

3. Thawing stage – Shoulder motion slowly improves during the “thawing” stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.

For some people, the pain worsens at night, sometimes disrupting sleep.

DIAGNOSING FROZEN SHOULDER

To correctly diagnose frozen shoulder it is important to rule out other potential problems such as rotator cuff tears or shoulder joint arthritis.

Dr Pullen will thoroughly discuss your history and undertake a clinical examination of your shoulder. He will ask you to move your arm in certain directions to check your range of motion (active movement) and ask you to relax your shoulder whilst he manipulates the movement (passive movement). Frozen shoulder affects both active and passive range of motion.

In some cases patients may benefit from having additional imaging tests to rule out other problems. Imaging tests may include:

  • X-rays

  • Ultrasound

  • MRI (Magnetic resonance imaging)

FROZEN SHOULDER TREATMENT OPTIONS

Non-surgical options

Non-surgical options are usually the starting point in treating frozen shoulder. The aim is to control shoulder pain and preserve the shoulders range of motion. Non-surgical treatment options may include:

Medications – Pain relievers such as paracetamol, aspirin and ibuprofen may help reduce pain and inflammation associated with frozen shoulder.

Physical therapy – A physical therapist can advise you in relation to:

  • Range-of-motion exercises to help improve your shoulder movement
  • Advise you about positioning, and other strategies to minimise your pain
  • Use manual release (touch and massage) techniques to improve the mobility in your shoulder joint.

Your commitment to doing these exercises is necessary to regain movement and strength.

Surgical options

If your frozen shoulder symptoms persist after non-surgical treatments, Dr Pullen may discuss:

Steroid injections – Injecting corticosteroids into the shoulder joint might help decrease pain and improve shoulder mobility.

Hydrodilatation – Injecting sterile water into the joint capsule may help stretch the tissue and make it easier to move the joint. This is sometimes combined with a steroid injection.

Shoulder manipulation – Shoulder manipulation is done under a general aesthetic. Dr Pullen manipulates the shoulder joint in different directions to help loosen the tightened tissue.

Surgery – Surgery is usually the last resort. Under a general aesthetic Dr Pullen can remove scar tissue from around the shoulder joint. This surgery usually involves making small incisions for small instruments guided by a tiny camera inside the joint (arthroscopy).

POTENTIAL COMPLICATIONS

The surgery complications which may occur after frozen shoulder surgery include:

  • Shoulder stiffness
  • Restricted movement
  • Infection
  • Numbness or tingling around the shoulder.

Dr Pullen will discuss with you in detail the potential complications and risks in relation to the surgical and non-surgical approaches.

Mr Troy Keith
Dr Christopher Pullen
BSc(Hons), MBBS, MPH, FRACS, FAorthoA.
Orthopaedic Surgeon

If you have any questions please contact my team:

 Frozen Shoulder Treatment Melbourne:

Dr Christopher Pullen – Orthopaedic Surgeon

If you have any questions or would like to make an appointment, please feel free to contact my team:

Proud member of Royal Australasian College of Surgeons and Australian Orthopaedic Association.

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Frozen Shoulder Surgery Melbourne

Dr Pullen treats patients from all over Victoria in relation to shoulder injuries. He consults with patients at the following practice locations in Melbourne including East Melbourne and Ringwood.