Frozen Shoulder - Looking for Advice

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#1

Initial diagnosis was 11/2010. I got a cortisone shot and took roughly 18 PT sessions. All got better by March 2011. May 2011 the pain returned and my ROM was decreasing rapdily again. I got another cortisone shot but no more PT per doctor. Early August 2010 no improvement what so ever so a 3rd cortisone shot. No good so I changed doctors for another opinion. I went on a NSAID for 6 weeks. Initially, the pain was greatly reduced by my ROM was still poor.

Mid-October 2011, I had arthoscopic surgery to clean-up my capsular, repair a tear in my rotator cuff, impingement and bicep temonty (sp?). Things were really mobing along for the next 6-8 weeks and returned to work. By January I was back at the same point as I was before my surgery.

Back on he NSAID and 24 PT sessions. After my iniital 12 sessions my QuickDash score was 67.....good. Started my 2nd round of PT and after 12 sessions my condition got worse. My quickDash score fell to 34...most recebnt one is now 27.8

Continued on NSAID mediciation with no relief and not sleeping but 2-3 hours at best daily. Saw my doc who gave me another cortisone shot last Wednesday and nothing except balloon my BGs into the 350s. Doc mentions lots of scar tissue when trying to inject needle for shot.

At don;t know what to do at this point.......another surgery.....maybe open surgery.

Anyone in a similair position?

#2

I have had frozen shoulders on both sides, and the only thing I can say is it takes a LONG time to get better and you must be diligent in the rehab exercises.
I did not have cortisone or surgery, just PT, massage, acupuncture and yoga.
I guess I sort of adapted to living with a compromised range of motion. I could not put my coat on without help, could not get things off a top shelf, washed my hair with one arm. It was even difficult pulling up my jeans in the morning.
After about 3 years, it very slowly started to get better. And, as the pain dissipated I was able to do more of the exercises, which increased the healing.
Currently I have 90% range of motion in both arms, and am extremely grateful.
Good luck and best wishes.

#3

Hi Marty, I had frozen shoulder (FS) about 15 years ago. It was extremely painful like you described. I never got a cortisone shot as the bone specialist that I saw told me that this is common in diabetics and there really inst nothing that can be done (medication wise). So, what you went through is really bad to hear. Doc told me that time and therapy exercises are the way to treat this. He was right. They took X-rays and all of that but one thing I swear did help me....as painful as it was. That is, a special therapy exercise he told me to do 3x a day. That exercise is this:

Stand perpendicular to a wall (not facing it with your FS as close to the wall as you can get..maybe 2" away). Put your open hand on the wall behind your shoulder and crawl with your fingers walking your hand up the wall. Walk your hand up as far as you can go (likely it will not be very far as it is PAINFUL). Try not to step too far away from the wall. Try and push past your pain and go as high as you can. This is important...try and push yourself past the pain. Repeat this about 5 times in one session. Do this 2-3X a day. You will note that soon you will be going higher up the wall and the pain will reduce.

Anyway, this sounds crazy I know. I was skeptical. But, dang, it worked. After about a month or two things got better and soon my FS was gone! That therapy worked amazingly well for me ...as painful as it was to do.

One note, about 3 years later I got FS on my other shoulder! I did the same thing and was cured in 2 months. You sure sound like you have some other issues going on too. That may complicate matters. If you can, this is worth a try and its free. Best...

Ken

#4

Hi Marty. I can totally relate to your situation. I have had bilateral frozen shoulder. It’s been almost 3yrs since the initial onset and I still have pain and ROM issues. After having surgery on both sides I’ve come up with my own theory about the recovery after surgery. I believe all the info you read about the stages and timing for those, and that it is an inflammatory process. I think that if someone truly has frozen shoulder,the outcome will depend on what stage of the process the shoulder is in. For example, my first surgery was well into the the frozsnstage. It hadn’t gotten worse or better, I justcouldnt live with the pain and restrictions any longer. The outcome was an easy recovery and back to work with limitations in a few weeks. During myrecovery is when the other shoulder started acting up. Immediately got an injection with no improvement. Scheduled surgery and expected the same outcome.

#5

Bernstein's most recent teleconference talked about steroid use, particularly for things like frozen shoulder. He really cautions against the use of steroids, raising your blood sugar is not good and I believe that high blood sugars have a role in the inflammation and problems that cause frozen shoulder.

Frozen shoulder is an inflammatory problem and over time your tendons can thicken, your bursa can be damaged and you can end up with a condition that just won't go away. And eventually, you can get to the point where the inflammation causes impingement, pinching your nerve and causing pain, low of feeling and control and spasms all down your arms. It sounds like you are to this point.

Bernstein recommends release therapy. There is an entire subfield of chiropracty devoted to this therapy, generally called Active Release Therapy. This is not a therapy you will get from mnost PTs and it isn't what a surgeon will suggest. In fact, must of the "medical establishment" really looks down on chiropractors. You may well need surgery, but it is at least worth looking into ART.

#6

Marty, Melitta posted a couple of conversation regarding frozen shoulder, one at https://forum.tudiabetes.org/topics/frozen-shoulder-1?commentId=583967%3AComment%3A1320387.

bsc recommends active release therapy, and I'd follow that recommendation if you can find a good extremity practitioner (C.C.E.P.). Here's one in Tampa: http://bayviewmedicalandrehab.com/staff.php I've had C.C.E.P. done for ulner nerve release -- painful as HE**, but have never had to return because I've kept up with the stretching exercises since.

Good luck!

#7

I have had FS for the past 3 years. I didn't have any surgery, which I avoid like the plague. I also didn't have any steroid shots b/c I had them for another problem and they raised my BS to 400. I do a lot of stretching exercises, and my ROM has increased about 50% from when I began. I always try to take the conservative approach to deal with my problems. The ART that bsc suggested sounds like it is worth checking out before you consider any more surgery. Best of luck.

#8

I had it in my right shoulder for about 2 years. I walked around with the inabilit to lift my arm for about 3 months (convincing myself this was a normal muscle pull -- I am delusional like this regularly) before I awoke one night in such pain we ended up a the ER the next morning just to get some relief. Finally finding my way to a shoulder specialist I recluctantly agreed to a cortisone injection (and dealt with the sky high BG). There was instant relief for me from the super intense pain but then I went into PT. I was a maniac about the PT. There was improvement but some of the most intense pain that was closer to the neck and the ability to turn the neck didn't return. The PT then opted for massage on those areas -- HUGE DIFFERENCE! Still not perfect but those treatments and hot showers teaming down on the area helped. I was ready to try accupuncture at the recommendation of someone when poof -- it went away - -as mysteriously as it appeared it went away. Almost 2 years to the day from start to finish. I had never even considered surgery for it becuase I knew it wasn't from a physical injury and everything I had researched had said it would ultimately vanish and sure enough it did. But it was brutal getting there. Now I have the start of it in my left shoulder. I am exercising it like a mad woman trying to keep it from getting the best of me. So far I've been able to keep it at bay but I do not have full range of motion in that arm. But I seriously recommend deep massage with a PT and maybe this time I will even try the accupuncture route. I figure, I'm used to needles in my fingers and abdomen, what's a few more needles to try to make my shoulders ok. It's a lot better than a scapel.

#9

Did your physical therapist ever try kinesio taping. After my carpal tunnel surgery I still struggled, until my therapist did this technique to my wrist.

#10

I didn't finish my previous response, but basically I feel as though the surgery outcome may be dependent on where the shoulder is in the inflammatory process.The inflammatory process is the process and if you "cut" the shoulder, that doesn't change the body's inflammatory process and it continues until the bodies ready to be done with it. I don't think I would have an open surgery, your outcome may not be what you would expect or want. My second surgery on the other shoulder, which was done during the freezing stage, had a completely different outcome and I am still left with pain and decreased ROM in that shoulder, now still a year and half later. I have also tried acupuncture, massage which feel good at the moment but didnt seem to have long term effects. I also had ongoing OMT which seemed to help alittle with the pain that I was having, but for just a day or so. And I would definitely recommend the kinesio taping. I would have my shoulder taped after every PT session before and after surgeries and I would say that the tape gave me the most relief for the longest amount of time. Good Luck!

#11

My right shoulder locked up about 6 years ago. Took a number of doctors to finally figure out what was wrong, and I then started seeing a sports medician doctor. He knew right away what was going on, and recommended PT to start. I did very painful PT for about 3 months with little improvement. He then recommend "manipulation surgery", which is where they put me out, then the doc litterally broke the frozen muscules by moving my arm where it would not move before. In his words "move the arm until it goes "SNAP!", and all the nurses in the room shudders from the sound." The first surgery was bad, as the pain block didn't work right and I was out of it for 2 weeks. It took about 6 months recovery and more PT, but I finally gained back 90% of the movement in my right arm. That from as little as 20% movement.

2 years ago my left shoulder started acting up. I went back to the same doctor, and he agreed that it was back to manipulative surgery. I was ready for it this time, I figured a few months of pain were better than what I was going through now and would continue to go through. This time the surgery went much better. The pain block was done with ultrasound to get it right and it worked. However, this time I only gained about about 70% of the movement. I figure it is due to not having PT before, and not much after the surgery. PT is painful, but DO IT! It will make all the difference in the world!

So, today I'm actually using massage therapy to help out. No pain, just some movement issues in my left shoulder. But the place I currently work for pays for massage therapy for all it's office staff as a bonus, so I'm taking 100% advantage of that perk. The therapist is good, and knows how to work these types of muscle problems. It's not as good as the surgery, but it does help quite a bit.

Frozen shoulder is painful. And the cure is even more so. But stick to it, 110% and you will be so much better off. If I'd done even near to my left shoulder what I did to my right I would be in great condition today. Basically I had to learn the hard way that the PT is key and extremely important to do as much as you can handle.