Frozen Shoulder Treatment
in Rockhampton

What is going on

Frozen shoulder is a self-limiting inflammatory condition of the shoulder capsule that runs through three overlapping phases — a painful 'freezing' phase (weeks to months), a stiff 'frozen' phase (months), and a gradual 'thawing' phase (months to years). Patients describe deep aching pain at night, marked loss of range — particularly external rotation — and difficulty reaching behind the back or up to the head. The condition is most common in patients aged 40–60, in women, in diabetics (where it's both more common and slower to settle), and after periods of shoulder immobilisation. It can also follow rotator cuff injury or shoulder surgery. The natural history is favourable — most patients regain useful function — but the timeline can be 12–24 months and the painful phase is genuinely disabling.

Not sure if this is the right diagnosis? The shoulder pain hub and shoulder injury hub triage the differential by anatomical location.

What the operation involves

**Arthroscopic capsular release** is the standard operation — keyhole release of the thickened capsule from inside the joint, releasing rotator interval anteriorly, the inferior capsule, and the posterior capsule as needed. **Manipulation under anaesthesia** alone is sometimes performed for milder stiffness without arthroscopy, though many surgeons prefer the controlled visualisation of an arthroscopic release. The procedure is typically done under regional block plus general anaesthesia as a day case, takes around 30 to 45 minutes, and is followed by a sling for comfort only — early movement is encouraged from day one. Full clinical detail is on the education page, and the frozen shoulder education page covers the underlying condition.

For full clinical detail — incision, anaesthetic, post-operative instructions and the printable patient handout — see the frozen shoulder release education page or the shoulder surgery overview.

How this case is handled

The practice's first consult focuses on confirming the diagnosis (frozen shoulder is over-diagnosed — many stiff painful shoulders have a different mechanism), establishing where the patient sits in the natural history, and matching treatment intensity to phase. Patients in the painful 'freezing' phase often benefit most from injection or hydrodilatation. Patients in the established 'frozen' phase often benefit most from physiotherapy. Surgical release is reserved for the minority who fail this graduated approach. Hand therapy and physiotherapy with Ruby Doolan at Extend Rehabilitation is built into the post-operative pathway from week one.

Fees, Medicare rebates and the surgery-quote process are on the fees page. The case for seeing a fellowship-trained surgeon — and what fellowship training adds — is set out separately. GPs can find the referral pathway, urgency triage and what to include in the letter on the referrer page.

What this operation is billed under

The procedure is covered by the following Medicare Benefits Schedule items. Surgeon, anaesthetist, assistant, hospital and prosthesis fees are quoted separately and in writing before surgery — see the fees page for the practice's quote process and an explanation of why surgical fees follow the Australian Medical Association schedule. Surgery does not proceed without itemised written informed financial consent.

Item 48954 Shoulder arthroscopy with capsular release

The MBS item for arthroscopic capsular release of the frozen shoulder

Patient questions we hear most

• How long does frozen shoulder last on its own?

  The natural history typically runs 12 to 24 months from onset to substantial recovery, though this is highly variable. The painful 'freezing' phase is six to eight weeks of escalating pain and stiffness. The 'frozen' phase is four to twelve months of stiffness with reduced pain. The 'thawing' phase is six to twelve months of gradually returning movement. Diabetics tend to take longer at every phase. Most patients eventually regain useful function without surgery, but the timeline is genuinely disabling for some — particularly those whose work or sleep depends on shoulder movement.

• What is hydrodilatation and how does it work?

  Hydrodilatation is an injection performed under ultrasound or radiological guidance: the shoulder joint is filled with a mixture of local anaesthetic, corticosteroid, and saline. The volume distends the capsule and can rupture some of the adhesions, while the steroid settles the inflammation. It's done as a day-procedure, takes around 20 minutes, and is well-tolerated. It often gives meaningful relief in the painful and frozen phases and may avoid surgery altogether. The practice arranges hydrodilatation through Mater Private Hospital Rockhampton.

• Will I need surgery?

  Most patients with frozen shoulder do not need surgery. The graduated approach — physiotherapy, injection, hydrodilatation — settles the majority over six to twelve months. Surgical release is reserved for the minority with persistent disabling stiffness despite a thorough non-operative trial. The threshold is individual: a manual worker with an overhead job may move to surgery sooner than a retired patient with similar restriction. The consult sets out where the patient sits and what to expect on each pathway.

• How long is the recovery from arthroscopic capsular release?

  Movement starts the same day to prevent re-stiffening. The sling is for comfort only and is usually off within a few days. Office work resumes within a week. Driving is reasonable once the shoulder is comfortable enough to manage steering one-handed. Physical work and overhead activities are graded back over four to six weeks. Final outcomes are usually settled by three months. Diabetics tend to be slower and may benefit from longer therapy support.

• Can frozen shoulder come back after surgery?

  Re-stiffening after capsular release is uncommon when post-operative therapy is engaged with consistently in the first six weeks. Recurrence is more common in diabetics, in patients who can't tolerate the early movement programme (often because of pain), and where there is an underlying cause that wasn't addressed (a missed cuff tear, calcific deposit, or another inflammatory condition). The first review at two weeks specifically checks for early stiffening so it can be caught and corrected before scar tissue matures.

• Is shoulder bursitis the same as frozen shoulder?

  No. Shoulder bursitis (subacromial bursitis) is inflammation of the bursa under the acromion and gives pain on overhead reaching with relatively preserved range of motion when the pain is settled by injection. Frozen shoulder is a contracture of the joint capsule itself and gives loss of range that does NOT improve when pain is blocked. The two conditions are commonly confused and often co-exist; sorting out which is the dominant problem is part of the diagnostic consult, because the treatments are different.

• How much does frozen shoulder surgery cost? What does Medicare cover?

  Arthroscopic capsular release is performed under regional and general anaesthesia at Mater Private Hospital Rockhampton, so a separate anaesthetist gap applies on top of the surgeon and hospital fees. The practice quotes the surgical fee in writing before booking — Medicare item, rebate and out-of-pocket gap shown separately. Most major private health funds offer no-gap arrangements. The fees page covers the full process; surgery does not proceed without itemised written informed financial consent.

More general questions about appointments, fees and the practice on the FAQ page.