Has surgeon recommended capsular release too early?

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Hi - I am new to the goup & hope I can get some advice here smile. I injured my shoulder in Jan this year when I slipped in the garden. It immediately felt a little painful but I naively thought it would heal itself. I continuted to have a slight pain in my upper arm then in mid April the pain started to get worse & I noticed that I was losing movement in that arm. Then went to see a physio for 4 weeks & he identified it as an FS. Through my health insurance I went to see a surgeon about 2 weeks ago (he seems to be quite well qualified, specialises in shoulders & teaches surgery at the Royal College of Surgeons in London). I am still in the "freezing" stage as I am still getting a lot of pain. He says my FS is "severe" due to amount of movement lost. He thinks injections would not work (did not say why) & recommended a capsular release. He reckons he has a 1 - 2% failure rate with this, and that if the shoulder went stiff afterwards he would do MUA (which I do not want - it sounds painful!). I am concerned that his attitude seems very "gung-ho". I have read that this procuedure is usually done in the "frozen" stage. Has anyone had experience of capsular release in the freezing stage? I am really unsure of whether or not to go ahead with this surgery and cannot seem to get some solid advice from anywhere. Thanks in advance for any help / advice.

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  • Posted

    Dont despair the pain will subside. I thought the same as you, I popped painkillers and it took a couple of months. That gut wrenching pain when you knock your arm went so it was worth it just for that. Keep at the physio by yourself doing the walking up the wall with your arm was particularly good for me. Good luck
    • Posted

      Thanks Grahame - that is very encouraging and really good to knowsmile.

    • Posted

      Linda, how are you doing now? Would u recommend the surgery now?
    • Posted

      Hi. Saw physio yesterday. It seems that I have been pushing myself probably too hard on the exercises, & he has toned down 1 that he gave me. Still have pain but definitely feel more positive since having the surgery smile

    • Posted

      Good for u..glad it all worked out nd remember it's a slow recovery so take it easy on the exercise..

  • Posted

    Hi Linda, I had the capsular release as well almost three weeks ago. I was pretty amazed what big operation it was, it knocked me for six. I am no doing the pt and also stretching for all I am worth. I have seen several physios and the best one told me you really have to push yourself through it, to he edge of pain and do it little and often. Walking up the wall, all that stuff. I think it usually takes about six weeks, so fingers crossed for both of us!
    • Posted

      Hi. After my operation I actually felt quite good, which I was not expecting. What I was also not expecting was that the road to recovery would be so long! My shoulder was well & truly frozen - I had very little movement left in it, so that seems to have made my recovery more of an uphill struggle. I am still taking strong painkillers and am really trying to push myself with the exercises. I feel that I have turned a corner this week but think that it will still take quite a while to get back to about 80% of my movement, which is what my physio says they aim for. As you say, it usually takes about 6 weeks but physio says it may take me about 12, which is really disappointing, but at least I do now feel that there is light at the end of the tunnel. Hope that you are making good progress smile.

  • Posted

    Hi. Latest update. Now 4.5 weeks since surgery & saw my consultant for my follow up today. Although I have religiously been doing my exercises, he reckons that the inflammation is trying to freeze me up again. My shoulder has been quite painful & whilst I did try dropping back to paracetamol, I have ended up going back on to the co-codamol. The consultant has given me 1.5 weeks to really try to get more movement (no pain, no gain he said - as if I had not been doing that already!) or else he will need to gie me an injection & he says that he does not want to do that (I forgot to ask him why not sad). My shoulder was well & truly frozen before the surgery and he just says that it is the nature of the beast, but I am now feeling thoroughly fed up. Clearly I will really go for it in the next 10 days (I think that I may have to buy a few more dozen gelpacks for the freezer), but does anyone happen to know why the injection is not a good idea?

    • Posted

      I am only at 3 months into my froZen shoulder I thought I was going to wait a year before doing any surgery! Today at my dr they gave me cortizone injections but they made me make the choice if I wanted it or not! I did it so I will let you know how it goes over the next few days! The put me into surgery scheduling for mua and to scrape out all the scar tissue but your post is why I am really reluctant! It sure dosnt sound like it helps get you out any quicker? What is everyone else feeling about doing surgery this early! I have the rom of a t rex!
    • Posted

      I woke up at 2 am in agonizing pain from the cortizone injection? Not sure if that's what they r recommending but as of now I would say no cortizone):

    • Posted

      Hi Alison - wow, that sounds awful. I hate the way doctors make you choose whether or not you want something done. They are the experts! Since I saw the consultant I am really going for it with the exercises - that's all I can do really. I hope that the pain has subsided now for you since the injection.

    • Posted

      Linda, how are you doing any improvement? My injection of cortisone I guess has helped the pain but my rom went down drastically! It made my shoulder stiffen up so tight! I'm headed back to pt on today and will see how that goes then I think I'm going to head to surgery! Such a nightmare! My other arm is so painful it am praying it's just from overuse trying to compensate but I can barely move it today! But I did a lot of major physical activity this weekend with just my poor left arm! I hope u are feeling better and can get through without going back in for more torture!

    • Posted

      Hi Alison. I hope that you are felling better after your cortisone injection. It is really bad that it made your shoulder tighten up sad. This really is an awful condition to have to live with. I feel that I have turned a corner this week with my physio. Yesterday I was able to use both hande to wash my hair & was able to put the washing out. I am still taking the strong painkillers as I am really having to push mnyself with the exercises so my shoulder does get quite painful. However, getting more of my movement back has made me more hopeful that in a few months I may feel that life is getting back to normal. Hope that you get yours sorted out soon

    • Posted

      Oh I am so glad you are feeling a little better! I've been worried about you! Hoping you didn't freeze back up ! Rough day for me pain is crazy unbearable! I'm really just over it loosing my will to fight! My drs are being really secretive but I am getting a new MRI hopefully! There is a part of me that feels like something is wrong from my initial surgery? Who knows it's just crazy oainful and I'm coming up on 4 months with no break from the pain my bp is through the roof! Keep me posted Linda my mua and capsule release is nov 30

    • Posted

      I have had 2 cortisone shots. The first one did absolutely nothing, so on the advice of my physical therapist, I went back to my orthopedist a month later to get an ultasound guided shot. I will say that after getting the shot at about 4pm, by 8/9pm my arm was throbbing and really sore. Some ice and ibuprofen helped. After about a week from the shot, I felt that I was having fewer "big Pain' events each day, but still not much difference.I was unsure if the shot had helped a bit, or if I was just getting smarter about avoiding really painful movement. After about 8-9 days, I was feeling a bit better and saw my PT. He measured and some of my range of motion was a bit better. So, I am encouraged. The shot is not what I had hoped for, but it does seem to be of some benefit. My current fear is that I now seem to be developing stiffness and issues in my other shoulder....nothing like a yoga instructor that can hardly move her arms! Frustrating.....

    • Posted

      Hi Alison. I am making progress. have move ROm now. Can almost get my arms straight up in the air. Can drive again (only short distance) and wash my hair with 2 hands! Shoulder still painful so still on the pain killers. I have to be careful - if I do do much PT then my shoulder seems to get quie inflamed so it is quite hard getting the right balance. I see the consultant on Monday so will see if he says whether or not he wants to give me a steroid injection. Hoiw are you doing?
    • Posted

      Sorry to hear that karenus. Hope that your other shoulder is ok. I do get soreness in my ok shoulder but think that if simply because I overuse it as the other one is not up to scratch. Thanks for the feedback on the injection. I see my consultant on Monday so will see if I get the shot or not sad. Hoping you are improving

      .

    • Posted

      Hi madiniah33615. Thanks for the encouragement. I am beginning to realise that this is a long process. My surgeon definitely glossed over that! I left hospital with the impression that within a few few weeks I would have little pain & things would mostly be back to normal! I am just now understanding how wrong that was ....

    • Posted

      Linda, I have taken the approach to just do nothing! For a few weeks now I have not done any pt or my dyna splint! The pain is def less! I have very little rom but just need a break! I am scheduled for the mua and cap release on nov 30 so I have 2 month to decide if I will do surgery or not for now I'm enjoying a little break from it all! I went to pt this morning just to see how I was and if it still cause so much pain! She could barely move me at all but I just told her I was taking a break and if she could just work on relieving my neck a little! Just kinda done): I am going on a pretty adventurous trip with habitat for humanity in 2 weeks from today just going to get through it one handed! Then maybe I'll be ready to fight this again! We will see! I read an article about just doing nothing and waiting it out it sounded pretty good!

    • Posted

      Hi Alison: this forum gave me the courage to quit the heavy PT and to tell my doctor I was taking a break & doing nothing. He looked rather surprised, but quickly respected my decision & seemed to take me more seriously after that for adjusting pain meds, arranging cortisone, etc. Six months later I started again with a different PT once I was well into the thawing. I didn't feel this time like PT was 'being done to me', but rather was retraining my shoulder with care & professionalism. Enjoy the break biggrin And the blessings on a Habitat trip!  Liane

    • Posted

      Hi Alison. From this forum the concensus seems to be that PT is no help so that sounds like a good decision. I used to get a lot if pain at the top of my back near to my neck which s horrible. It wa so bad that i struggled to sit comfortably in a lot of chairs. I only found out after surgery, that I was getting that pain as I was trying to do stuff with my bad side, but as I could not lift from my shoulder joint I was lifting my WHOLE shoulder, from the neck across to the shoulder joint and that is what was causing me so much pain. Not sure if that is of any help to you. I think that 1 hnded is a good way to go, unortunately. Best of luck.
    • Posted

      Thanks for your kind words linda....I visited my PT and told him of my concerns related to my other (so called heathy) shoulder. He took some measurements of my ROM and definitely saw that I was having issues with both shoulders (he cannot diagnose, so he stayed away from that, but gave me some gentle strengthening exercises to do to try to keep that one healthy). I am about 10 days into an anti-inflammatory diet that my integrative MD recommended due to FS and some peri-menopause symptoms (mostly plants and no dairy or white starches for now) and while it is way to early to see any difference in my shoulder, I do feel a bit clearer and have lost a few pounds too ( I am at a healthy weight, so don't want to lose too much).

      I had a horrible experience this past week while husking sweet corn! It slipped a bit and my frozen shoulder jarred....I thought I was going to pass out from the pain! I took some ibuprofen and iced it immediately, so hopefully I didn't set myself back too much!! Yikes....the simplest movements can be the most painful!

      Good luck with your progress....my advice would be to ask for an ultrasound guided shot if you get one, as the first shot I received that was just given in the general area did nothing for me. Not sure how your health care works, but here in the US, my co-pay for the ultrasound guided shot was about $300. Worth the bit of good it has done for me though.

      Peace and health....

    • Posted

      Hi Karen. Sorry to hear that you jarred your shoulder - I do remember the pain. I did that once when I was rushing for a train & ended up sitting on the train crying! I will ask my consultant about the ultrasound guided shot when I see him. Best of luck with your progress.

    • Posted

      Hi Linda, Im just like you tomorrow 4 weeks after capsular release, still lots of pain and limited movement. Im doing physio once a week, going to the gym for 5 or 10 min of exercise and jump in the pool and hut tub fro another 45 min. All this things really make me feel better some how even when they dont take my pain away fully.

      The pool water is relaxing so the hut tub is easier to move your joint.

      Im wondering when they talk about injection which kind of injection people are talking about. Is an injection for pain or avoid more damage, or to help to resolve the problem???

      Thanks a lot and I wish you a speedy recovery. Id beeing suffering mine for over 4 years until finally someone listen to me and decided to do the surgery.

      Thanks for all your info is very helpful.

      Many blessing your way!!!

    • Posted

      Hi Oliveria:

      The injections I had were cortisone shots, intended to decrease inflammation in the joint & promote healing. The effect lasted at least 10 weeks each time for me, helping me to do the exercises/stretches better & have less intense pain.

      Cortisone in itself is not a cure. In Canada (and probably elsewhere) we're allowed cortisone into joints once every three months, as a pain reliever & anti-inflammatory.

      My first injection didn't work because my joint was already too hardened with the FS, and it was done in a regular clinic, not guided by imaging. The shots that worked well for me were given at the start of the thawing stage & again three months later while still thawing. I also had it injected into my second shoulder to thwart the beginning symptoms of FS in that one too.

      Hope that helps to explain "the injections people are talking about" - at least the cortisone ones! (Another drug called xiaflex is also talked about here occasionally, but is not widely available. Cortisone has been around over 40 years, so I'm personally okay with it; whereas, xiaflex injections are new and not approved for FS in Canada.)

      Liane

    • Posted

      Hi, I had my capsular release and mua yesterday! Was pretty rough I was really sick from anestia so threw up all day but still went to my pt apt 2 hours after getting released! I can not move my arm by myself but people can move it for me! So I have someone move my arm above my head every 3 hours hoping it works and keeps it unfrozen! Pretty painful but I'm praying it will do the truck!

    • Posted

      Hu Liane,

      Thanks a lot for your replay, your information is very helpful for me.and others.

      I had capsular release in my hip a month ago. I do not have a lot of ROM yet, still a lot of pain I do feel my leg and hip much better in a way.

      I still.go to physio every week, gym for bike ride and swmming poll to exercise every day.

      Im hoping my ROM somehow will come back and everything will be normal again.

      Thanks and many, many blessings to you.

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