Frozen Shoulder Symptoms-Is Surgery Your Best Option?

Manipulation under anesthesia, or MUA, is a procedure where a patient is stretched and adjusted under general anesthesia.  It is a well accepted treatment for conditions such as frozen shoulder.

I have personally been doing MUA for almost a decade, so I can speak from experience.  Basically, a patient is put under general anesthesia and turned into a yoga master by a team of two experienced physicians.  Orthopedic doctors usually limit themselves to frozen shoulder and post-knee-arthroplasty adhesions.  Chiropractors do MUA for frozen shoulder and post-TKA adhesions as well, but also for chronic low back pain, hip pain, neck pain and headaches.

While insurance unfortunately does not typically pay for MUA for headaches, I can tell you, again from personal experience, that this procedure works exceedingly well for chronic headaches related to neck pain and tightness.  You can view one of our patient’s testimonials on MUA for chronic neck pain and headache by clicking here.

Our clinic is always looking for ways to make any treatment more effective, so this particular article was of particular interest.

Researchers compared arthroscopic surgery for frozen shoulder symptoms to an MUA combined with a local steroid injection given at the same time as the procedure.

Not surprisingly, the outcomes for the MUA for frozen shoulder were superior to those of the surgical procedure.  Further, when you compare how the MUA patient feels the next day compared to the arthroscopic surgery patient, it is night and day.

I remember one patient who had such restricted range of motion of his right shoulder that he couldn’t even put his hand on his chest for the Pledge of Allegiance.  It had been that way for some 25 years (he just “thought it would get better..”).  After 3 back to back days of MUA, he was in my office 2 days later ecstatic that he could almost completely lift his arm up to his head.  He noted he was a little sore, but that was the extent of his post-MUA symptoms.

For any of you who have had arthroscopic surgery on your shoulder, it probably wasn’t quite the same experience…

Sadly, few patients with shoulder pain that does not respond well to conservative therapy (and most of them will) will ever even know that Manipulation Under Anesthesia is even an option for them.

Ultimately, the authors of this study suggest that MUA for frozen shoulder symptoms should be the FIRST procedure done.  If the MUA is not effective, the surgical procedure can still be done, which has happened with only a single patient in the MUAs that I have done for shoulder pain.

If you had surgery on your shoulder, was Manipulation Under Anesthesia ever given to you as an option instead of surgery?


James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.


Please note: I reserve the right to delete comments that are offensive or off-topic.

One thought on “Frozen Shoulder Symptoms-Is Surgery Your Best Option?

  1. Dr. Bogash –
    What is the typical recovery period for patients who undergo MUA at your office? In addition, what type of rehab is recommended?

    I ask because I saw a frozen shoulder patient after 2 unsuccessful MUA; the rehab protocol for the first 6 weeks was immobilization in a sling with 2 sessions on continuous passive motion per day and then 6-8 weeks of PT afterwards (I think, I’m going off memory). By the time I saw her (seeking Active Release Technique Tx), she was very frustrated as she has been very diligent about doing 45 minutes of at-home PT daily in addition to that with the PT at her appointments. It had been over a year when I saw her & although we were able to increase her ROM about 50% over approx 8 visits, she chose to not come back for an additional round of treatment because I couldn’t guarantee her complete resolution and it was a 75 minute drive for her each way.

    Overall, immobilization for that amount of time seemed counter-intuitive and I can’t really say I was surprised that the frozen shoulder came back…

    Thanks for your input,
    Dr. Dani

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