Adhesive Capsulitis—Closed Manipulation

Definition

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
Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

Your doctor may recommend closed manipulation if other methods of relief have failed. This procedure can relieve pain and stiffness for some patients. In others, there is still some pain and swelling in the shoulder joint. If the closed manipulation is not successful, you may need arthroscopic surgery .

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have a shoulder manipulation, your doctor will review a list of possible complications, which may include:

  • Pain
  • Nerve injury
  • Damage to soft tissue
  • Instability or stiffness in joint
  • Fracture
  • Reaction to anesthesia used

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic disease such as diabetes or obesity
  • Previous shoulder surgery

Prior shoulder surgery may also increase the risk of complications.

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • Blood and urine tests
  • X-ray—to look for any damage to the shoulder bones
  • MRI scan—to look for damage to the shoulder structures

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.

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

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions

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

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Cough, trouble breathing, or chest pain
  • Severe nausea or vomiting
  • Pain becomes worse or swelling increases
  • Tingling or numbness that will not go away, especially in arms and hands
In case of an emergency, call for medical help right away.

Revisions

All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at HLEditorialTeam@ebscohost.com.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Editorial Policy | Privacy Policy | Terms and Conditions | Support
Copyright © 2008 EBSCO Publishing. All rights reserved.

Early detection is key to successful cancer treatment. Your health care provider can help you identify your risks and recommend routine screenings that could save your life.