Frozen shoulder, also known as adhesive capsulitis, is a condition in which the shoulder joint becomes painful and increasingly stiff. It usually develops through three stages: freezing, frozen and thawing.
Symptoms
Symptoms typically change as the condition progresses.
Freezing stage
During the first stage, the shoulder becomes increasingly painful and stiff. Night pain is common and may disturb your sleep.
Frozen stage
Pain may begin to reduce, but stiffness becomes the main problem. Rotation of the shoulder is often particularly restricted.
Everyday activities can become difficult, including:
- Washing or styling your hair
- Reaching overhead
- Dressing
- Reaching behind your back
- Putting on a coat
- Fastening a bra
- Sleeping comfortably
Thawing stage
During the final stage, pain is usually minimal and shoulder movement gradually begins to return.
Causes
The exact cause of frozen shoulder isn’t always clear.
In some cases, symptoms begin after a minor injury, surgery or a period when the arm has been kept relatively still. The condition occurs when the lining and capsule surrounding the shoulder joint become inflamed and gradually tighten, restricting movement.
Frozen shoulder most commonly affects people between the ages of 40 and 60 and is more frequently seen in women.
Diagnosis
Frozen shoulder has a characteristic pattern of restricted movement that can usually be identified during a physiotherapy assessment.
Your physiotherapist will examine how far you can move the shoulder yourself and how far the joint can be moved with assistance. They’ll also discuss the progression of your pain and stiffness.
An X-ray may sometimes be arranged to rule out other causes of restricted movement. Further investigations are not usually required.
Treatment Options
Frozen shoulder is a self-limiting condition, meaning it normally resolves over time. Treatment focuses on managing symptoms, maintaining useful movement and adapting rehabilitation to the stage of the condition.
Phase-specific exercise
The right exercises depend on whether your shoulder is in the freezing, frozen or thawing stage. Pushing too aggressively during a painful stage may irritate the shoulder, so your programme should be carefully tailored.
Pain management
During the freezing stage, treatment may focus on helping you manage pain and sleep more comfortably. Your GP or pharmacist can advise on appropriate medication.
Steroid injections
A corticosteroid injection may be helpful when pain is severe or difficult to manage, particularly during the freezing stage.
Hydrodilatation
Hydrodilatation involves injecting a larger volume of fluid into the shoulder joint to stretch the tightened capsule. This may provide additional movement for some people.
Manual therapy
Hands-on treatment may help relieve tightness in the surrounding muscles and soft tissues. It is usually used alongside an exercise programme rather than as a standalone treatment.
Progress reviews
Regular follow-ups allow your treatment plan to be adjusted as your symptoms change as the condition moves through each stage, helping you gradually restore a healthy range of movement.
Recovery Timelines
Frozen shoulder often follows three stages, with each lasting approximately six months:
- Freezing: pain and stiffness progressively increase
- Frozen: pain reduces, but stiffness remains
- Thawing: movement gradually returns
The full process commonly lasts around 18 months, although individual recovery times can vary. Treatment may not dramatically shorten the overall course, but it can help you manage pain, maintain function and recover movement safely.
When to Seek Help
Arrange an assessment when shoulder pain and stiffness are making everyday activities difficult, particularly when symptoms are worsening or disturbing your sleep.
Early assessment is also important when:
- You’re rapidly losing movement
- Your symptoms followed an injury
- You’re struggling to dress, wash or reach overhead
- Pain is regularly waking you at night
- You’re unsure whether your symptoms are caused by frozen shoulder
We’ll assess your shoulder, explain which stage you’re in and create a personalised plan that supports your recovery every step of the way.
Clinically Reviewed By
Phil Williams
Director and Consultant Physiotherapist
You DON’t need to suffer with shoulder pain
Shoulder pain should not stop you from staying active, sleeping well, or doing the things you enjoy. At Great Northern Physiotherapy, we’ll help you understand what is causing your pain and create a tailored plan to get you moving with confidence again.
Book your initial assessment and take the first step toward pain-free movement.
SHOULDER PAIN FREQUENTLY ASKED QUESTIONS
Yes. Frozen shoulder usually resolves over time. Treatment can help manage pain, maintain function and guide your recovery through each stage.
Forceful stretching can aggravate the shoulder, particularly during the freezing stage. Exercises should be appropriate for your current symptoms and stage of recovery.
It can, although the shoulders may not be affected at the same time.
Most people recover without surgery. Injections, hydrodilatation and tailored rehabilitation may be considered before surgical options.
Many people can continue working with temporary changes to their duties, workstation or lifting demands. Your physiotherapist can advise on practical adaptations.
Related PHYSIO SERVICES
To support your recovery, your physiotherapist may recommend one or more of our related services:
Book your initial assessment and take the first step toward pain-free movement.