On June 3, 2015 I had a outpatient procedure called “manipulation under anesthesia” (MUA) to the left shoulder for the diagnosis of adhesive capsulitis of the left shoulder. This condition is “frozen shoulder”. The orthopedic surgeon I consulted for this condition told me that this is a common ailment for patients with my disease process: secondary to RA or other inflammatory arthritis and/or diabetes. For the last two years I was unable to raise my left arm sufficiently to get through many of the activities of daily living. The MUA was followed by physical therapy that started the afternoon after the procedure.
I was put to sleep for the MUA because I was told the manipulation of a frozen shoulder is too painful to perform while awake. The orthopedic surgeon forces the arm through range of motion, hoping to break loose the adhesions that have caused it to freeze up. It is considered a minor “surgery” even though there was no cutting involved. I was sore after procedure, but there was no severe pain associated with the procedure.
Therapy started hours after the procedure. I had ten physical therapy treatments with some minor improvement to the mobility of the arm. The orthopedic surgeon was not pleased with my progress in therapy, stating that I’d lost mobility rather than gain due to inflammation. He recommended another procedure called a mini-arthrotomy of the left shoulder.
I had the mini-arthrotomy on June 17, 2015 during which, the surgeon made a small incision about 1/2 inch long to the front of the shoulder. He did not cut into the rotator cuff, but instead manually broke the adhesions away from the rotator cuff. I was sent home that afternoon with a device called a polar ice cube, which held ice water that circulated via an electric pump through a pad attached to my upper arm and shoulder by velcro straps. I had to keep this ice water circulating through the pad for the first 48 hours after surgery to keep inflammation at bay. My arm was also in a sling. I was instructed not to take the arm out of the sling at all for the first 48 hours then only to shower and perform what is called pendulum exercises.
Pendulum exercise is simply bending at the waist and letting the arm dangle downward. Using your feet you rock your body to let the arm swing like a clock pendulum with no forced movement at the shoulder. This exercise is also prescribed to help prevent frozen shoulder. The arm had to remain in the sling for two weeks. I was given Tylenol #3 for discomfort which I took minimally.
I returned to the orthopedic surgeon’s office on June 30, 2015 at which time two sutures were removed and steri-strips were applied to the site. It’s a small wound that had already closed. I was allowed to ditch the sling with instruction to wear it only if my arm was tired or if I felt I needed it in public to protect my arm from being bumped. Rather than return me to physical therapy, the surgeon gave me some simple home exercises to do to increase mobility. His goal has been to do the most minimally invasive treatment and to avoid inflammation.
I’m to return to see the orthopedic surgeon on August 25, 2015 for a re-evaluation. I can say that I have gained mobility in my arm, but I cannot raise it well. I cannot put it in the position that a grade-school kid would in order to get the teacher’s attention but I can style my hair with more ease, turn my palm over to accept change, close my car door, and many other activities of daily living I was unable to perform before. I do not think it has improved to the degree I feel the surgeon will be satisfied; however, I am satisfied.
I lived with this condition for two years where I could not even raise my arm above the level of my left ear because I was told that my shoulder would never be right and surgery would only worsen the condition. That has not been the case. No, my shoulder hasn’t been restored to 100% mobility, but I can use it again and that is worth a lot to me.