Arthroscopic release and manipulation under anaesthetic of frozen shoulder: after surgery care
You will not feel any pain during the procedure. Afterwards you may well experience pain due to the surgery performed inside your shoulder, although you will only have small scars following keyhole surgery. During the operation you will be given a nerve block, which is an injection of local anaesthetic around the nerves in your neck to numb the arm. This may last several hours, or even up to a day, after the procedure. As the nerve block starts to wear off, the feeling of sensation will return to the arm, often in the form of pins and needles to start with.
You should start taking pain relief before the block wears off and continue to take this medication regularly to begin with, in order to keep the pain under control. You will be sent home with adequate pain relief and clear advice on how to use these and look after your arm.
You should take great care of your arm while it is numb, as it is possible to injure it if you cannot to feel it.
Wearing a sling
You must wear a sling at all times while your arm is numb. Once normal sensation has returned you should use the sling for comfort only. You can take it on and off as you wish, especially at night. The sling is normally discarded between a few days and a few weeks after the operation. You may find it helpful to wear the sling at night, or alternatively you can rest your arm on pillows placed in front of you. If you lie on your back to sleep, you may find placing a pillow under your upper arm will make it more comfortable.
Please remember this operation has been done to try and improve the range of movement at your shoulder, so do not keep your arm in the sling for long periods without doing regular exercises. Discard the sling as soon as you feel able.
It is important to do the exercises described in the exercise section. Exercises are designed to try and maintain the improved range of movement achieved at surgery. You will be shown exercises on the ward after your operation and will need to continue with these at home and with the guidance of the physiotherapist you see in outpatients. If you have not received an outpatient appointment within a week of leaving hospital, please phone the physiotherapy department on 023 8120 4559.
The wound and stitches
The wounds after keyhole surgery are very small, although the dressings may seem quite large. You will not have stitches, but will have small sticking plaster strips (Steri-Strips) to keep the skin edges together. You will have waterproof dressings over these so you can wash and shower. If the dressings do become soaked through they will need to be changed.
A wound check will be organised for you with your GP practice or district nurse at around five days and 14 days, when the Steri-Strips will be removed.
Outpatient follow-up is usually arranged at around two to three weeks after your operation, to check on your progress and again at around six to eight weeks after your operation. Further clinic appointments are made after this as necessary.
Your shoulder will be painful to start with, so it is important to take regular pain relief. Try to use your arm for normal daily activities and maintain the exercises.
The pain should gradually improve over the first few weeks and months, as should the range of movement.
Sometimes the full range of movement does not return completely, in particular the movement of getting your hand behind your back.
Returning to work
When you can return to work will depend on your occupation. Most people in desk based jobs are able to return to work at around three to four weeks, but jobs requiring significant manual work or heavy lifting often require at least six weeks off work.
You can drive as soon as you feel confident, competent and in complete control of a vehicle. It is advisable to start with short journeys initially.
It is best to start with gentle activities and build up slowly. You should avoid activities where your arm is at or above shoulder height in the early stages after your surgery. You will be able to build up your level of activities dependent on pain, range of movement and the strength you have in your shoulder.