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What can I Expect from Frozen Shoulder Manipulation?

By Rebecca Harkin
Updated May 17, 2024
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Frozen shoulder, also called adhesive capsulitis or frozen shoulder syndrome, occurs when the mobility of the shoulder joint is restricted and painful. It is usually caused by a thickening of the connective tissue surrounding the shoulder joint because of scar tissue from a shoulder injury or forced immobility after surgery or injury, but it can also be associated with diabetes, thyroid, or autoimmune diseases. Frozen shoulder manipulation loosens the connective tissue by quickly pushing the shoulder past the restricted point into the normal range in only one to two sessions. Physical therapy for frozen shoulder, in contrast, usually requires many months of rehabilitation. Manipulation is painful and is typically only done under general anesthesia.

During a frozen shoulder manipulation, you will be placed on a table and usually given general anesthesia, although in some cases, local anesthesia may be used to numb the shoulder area. An orthopedic physician will rotate the shoulder above your head and then out to your side until the motion is arrested by the tightened connective tissue. Your scapulae or shoulder blade will be braced and the orthopedic physician will give a quick push to loosen up the bound connective tissue. The physician will then place the shoulder into another position, stabilize the scapulae, and give another quick thrust. Usually, this is performed on all angles of the shoulder that are restricted.

Following the procedure, you will need physical therapy to maintain the enhanced motion and prevent swelling. Physical therapy is typically needed for at least one to three weeks following manipulation. Sometimes, the procedure will need to be performed again to further increase the range of motion.

There are some risks associated with frozen shoulder manipulation that you should consider before agreeing to the treatment. In rare cases, the connective tissue can be torn or further damaged by the forced extension, which increases the chance of scar tissue forming, restricting the movement again. Physical therapy following the procedure can help prevent scar tissue from developing and prevent the return of the restricted movement. The excessive thrusting during the manipulation can also, on occasion, damage the brachial plexus nerve and may also break the humerus, or upper arm bone, and so it is not a viable option for people with osteoporosis. If this procedure does not improve the shoulder movement, arthroscopic surgery is an option to remove the scar tissue.

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Discussion Comments
By irontoenail — On Oct 31, 2014

@KoiwiGal - Frozen shoulder manipulation under anesthesia is definitely not something to be done lightly. I know it's longer and more painful for a person to just do physical therapy and hope to loosen the shoulder over time, but manipulation can really make it worse if it doesn't work well. And it's not really a matter of skill either, as there's no real way for the doctor to be aware of what's going on in there. It's just their best guess.

By KoiwiGal — On Oct 31, 2014

@clintflint - There are definitely some exercises for a frozen shoulder that can gradually make it feel better, but the problem is that it's difficult to start them without additional help. There's a reason they need to inject an anesthetic to do frozen shoulder manipulation, and it's because it is extremely painful.

Acupuncture is another option, as is physiotherapy, but if a shoulder is particularly bad I would insist that the doctor explore the more drastic options as well.

By clintflint — On Oct 30, 2014

My mother had a frozen shoulder for a while, probably because she is a borderline diabetic and it seemed like it was the most painful thing I've ever seen her experience. It's not just that she couldn't move her arm past a certain point. If it was jarred, or if she forgot and moved it quickly, she would turn white and almost seemed to blank out from her shoulder pain. It was awful to watch.

She ended up needing to have steroid injections and quite a bit of therapy to get it to stop hurting so much, although it still gives her trouble.

Unfortunately, even that much pain doesn't seem to have motivated her to start a regular exercise routine, which the doctor told her would definitely help to prevent it getting so bad again.

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