Capsular Release for Frozen Shoulder Info Consent

Q: How long does frozen shoulder last on its own?

Most people improve a great deal, but the familiar reassurance that it 'always resolves in one to two years' is more confident than the evidence supports. When researchers reviewed the studies, most improvement happened early and then slowed and plateaued, and a proportion of patients — by some measures a third to a half — still had some ache or stiffness several years later, though for most it's mild. People with diabetes tend to recover more slowly. Because 'just wait, it'll sort itself out' isn't a neutral piece of advice, the practice treats the pain actively rather than asking patients to endure it.

Q: What is hydrodilatation and how does it work?

Hydrodilatation is an injection — performed by a radiologist under ultrasound or X-ray guidance — that fills the joint with local anaesthetic, corticosteroid and saline to stretch the capsule from the inside while the steroid settles the inflammation. It's a low-risk day procedure. The evidence for it is genuinely mixed — some studies show a benefit for pain, others for movement — so where it's appropriate Dr Hirpara refers patients to radiology for it, rather than treating it as a routine step. For pain specifically, a steroid injection into the joint has the strongest evidence.

Q: Will I need surgery?

Many people settle with an injection and time and don't need surgery. But the practice doesn't treat surgery as a last resort reached only after months of struggling: if a steroid injection doesn't give adequate relief, arthroscopic capsular release is offered from that point. In the largest trial comparing the main treatments, all three landed within a few points of each other at a year — but people who had a release were the least likely to need any further treatment. The right path depends on the individual: how much the shoulder is affecting work and sleep, diabetes, and whether an injection has already been tried.

Q: 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 usually resumes within one to three weeks. 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. Most of the improvement comes over the first few months. Diabetics tend to be slower and may benefit from longer therapy support.

Q: 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.

Q: Is shoulder bursitis the same as frozen shoulder?

No. [Shoulder bursitis](/conditions/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.

Q: 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.

Why this operation has been suggested

Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment establishes the diagnosis. For long-standing stiffness we usually try non-operative care first. We consider surgery when that has not given enough improvement.

This operation is typically offered after 9 to 12 months of failed non-surgical management. It is a keyhole procedure to release tight tissue around the joint. This restores motion with minimum risk. You can expect almost immediate relief of pain. Range of motion improves dramatically. This benefit has not been seen with injections or physiotherapy alone. The main aim is to restore normal function and quality of life within six months.

Before the operation

Please fast for seven hours before your surgery. Stop taking blood thinners only after your surgeon gives specific instructions. Arrange for someone to drive you home. Bring a list of all current medications and wear loose, comfortable clothing. You may need an X-ray, MRI, or blood test beforehand. These checks help us plan your care safely. We also recommend an anaesthetic review to discuss your health history. This ensures you are ready for the procedure. Please follow all pre-op instructions from our team carefully to keep you safe and comfortable.

On the day

You present to the hospital's surgical admissions unit, where you are checked in and prepared for theatre. You meet the anaesthetist, who explains your care plan. This operation is done under general anaesthetic combined with a regional nerve block. You will be fully asleep for the operation, and the block — an injection that numbs the nerves supplying the arm before you wake up — provides pain relief for the first 12 to 24 hours after surgery. The anaesthetist will meet you before the operation and talk you through both parts.

You are then taken into the operating theatre, where the operation is performed. You wake up in the recovery area, where nurses monitor you while the anaesthetic wears off. Once you are stable you either go to the ward or go home, depending on the procedure and your recovery.

What the operation involves

Your surgeon performs this procedure using an arthroscopic, or keyhole, approach. This means they make several small incisions around your shoulder, including at least one at the back. Through these tiny openings, they insert a small camera and specialised instruments directly into the joint. This allows your surgeon to see inside clearly while keeping the cuts small and minimising damage to the surrounding tissue.

Inside the joint, your surgeon carefully releases the tight, stiff capsule that is restricting your movement. The shoulder capsule is a sleeve of tissue that surrounds the ball-and-socket joint. In frozen shoulder, this sleeve becomes thickened and tight, like a shrunk sweater. Your surgeon cuts through this tight tissue in a circle around the joint. This circumferential release ensures that the stiffness is addressed in all directions, helping to restore your full range of motion.

This technique is chosen because it allows for precise release of the tight tissue with minimal impact on the rest of your shoulder. It is considered a reliable method for restoring motion in carefully selected patients with adhesive capsulitis. After the release is complete, your surgeon closes the small incisions with sutures and applies a dressing. The procedure itself is focused on mechanically freeing the joint so that your rehabilitation can begin effectively.

After the operation

You will wake up in the recovery ward with your arm in a simple sling for comfort. You may feel sore, but we manage your pain with standard medication. Keep the wound dressings dry and clean. Most patients stay one night in hospital after this operation, though some are able to go home the same day. You must have someone stay with you for the first 24 hours. Do not drive for at least six weeks after any shoulder operation, regardless of which arm was operated on. You must remain in the sling while travelling. We will guide your stepwise rehabilitation once you are home. For more details, see Driving after upper-limb surgery.

Recovery

You will notice immediate relief from pain and stiffness after your arthroscopic capsular release. This is a key difference from injections or physiotherapy, which often take longer to show results. Some swelling and soreness are normal in the first few days. We manage this with simple pain relief and ice. Your arm rests in a simple sling for comfort, which you remove for exercises and washing. We do not use hinged braces or abduction pillows.

Your physiotherapist will guide your stepwise rehabilitation. You will start with gentle movements to restore motion. As swelling settles, you will gradually increase your activity. You can return to light daily tasks as movement returns and pain allows. Sleep may be difficult at first; propping yourself up with pillows often helps.

You must not drive while in a sling or if pain limits your control. Our policy requires no driving for at least six weeks after any shoulder operation, regardless of which arm was treated. You can drive once your surgeon clears you, typically at the six-week review. For more details, see Driving after upper-limb surgery.

Recovery varies between individuals. Your timeline may differ; your surgeon and physio will guide you based on your progress.

What can go wrong

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

If your shoulder remains stiff or painful despite the procedure, this may mean the release was not fully effective. You might notice that your range of motion has not improved as expected. This can happen if the joint capsule did not respond adequately to the surgery. You should bring this up at your next review so we can discuss further options.

In rare cases, the shoulder may become unstable or feel loose. You might experience a sensation of the joint slipping or a clicking feeling when you move your arm. If you notice sudden weakness or a feeling that the shoulder is giving way, contact the clinic promptly. We may need to assess whether additional support is required.

Some patients report persistent pain that does not ease with simple painkillers. This could indicate ongoing inflammation or irritation within the joint. If the pain worsens or spreads, do not wait for your next appointment. Call the clinic to let us know so we can adjust your management plan.

While serious complications are uncommon, any signs of infection should be taken seriously. Look for redness that spreads out from the wound, increased warmth, or swelling that does not go down. If you develop a fever or notice any unusual discharge from the incision sites, seek medical attention immediately. Early treatment is key to resolving these issues quickly.

The complications table on this page lists typical rates if you want the specifics.

When to call us

Call us if you develop a fever, increasing wound redness or discharge, or sudden severe pain. Go to emergency if you notice calf swelling or shortness of breath. Contact us immediately for loss of sensation or inability to move your limb. These signs need urgent assessment to ensure your recovery stays on track.

Where to read more

This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the Frozen Shoulder page.

Where to read more

This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the Frozen Shoulder page.