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Frozen shoulder, or adhesive capsulitis, is a condition that causes pain, stiffness and a reduction in range of motion in your shoulder. The condition develops gradually over time and can last for months or even years.
The exact cause of a frozen shoulder is not fully understood, but it is thought to result from inflammation and scarring within the capsule that surrounds the shoulder joint. The capsule is a soft tissue structure that provides stability to the joint and helps to keep the bones of the shoulder in place. When the capsule becomes inflamed, the tissues within it can become thickened and stiff, in turn restricting the movement of the joint.
Call or book online today and you could have your initial consultation for your frozen shoulder with a private consultant near you in as little as 48 hours.
Frozen shoulder can be identified by the following symptoms:
- Pain in shoulder, arm or neck
- Stiffness in your shoulder
- Limited range of motion
- Weakness
- Difficulty sleeping
What are the stages of a frozen shoulder?
There are three stages of frozen shoulder: freezing, freezing, frozen and thawing.
Freezing stage
Freezing is the earliest stage of frozen shoulder, lasting between two and nine months.
At the very begin in what's sometimes referred to as the pre-freezing stage, you may start to notice the pain that comes and goes in your shoulder when you move, whether that's turning over in bed at night or reaching up above your head. Over time, the pain intensifies as the shoulder becomes more inflamed, becoming achy and stiff, with movement becoming progressively more difficult.
Frozen stage
The frozen stage lasts between four months to a year, and is characterised by stiffness and difficulty moving your shoulder. At this stage, the pain in your frozen shoulder may plateau and even decrease, although due to the stiffness you may have difficulty carrying out your daily tasks.
Thawing stage
At the thawing stage, the stiffness in your shoulder subsides and you regain movement in your shoulder. Pain in your shoulder should also start to fade, yet may flare up now and again as the stiffness eases. This stage typically lasts for a year, although can last longer.
How long does frozen shoulder last?
Frozen shoulder can last anything between six months to three years, with the length of each stage varying from person to person.
What causes a frozen shoulder isn't fully understood, but the following factors have been linked to its development:
Injury
Injuries to the shoulder, such as a rotator cuff tear or a dislocated shoulder, can lead to inflammation and scarring within the shoulder capsule. This can cause the capsule to become thickened and stiff, restricting the movement of the joint and leading to frozen shoulder.
Surgery
After surgery, shoulder immobility is often necessary to promote healing, but in some cases this can cause the shoulder to become stiff and painful. Frozen shoulder may develop as a complication after shoulder surgery, such as a rotator cuff repair or total shoulder replacement.
Underlying medical conditions
Certain underlying medical conditions are also linked to an increased risk of developing frozen shoulder, such as:
- Cardiovascular disease
- Cervical disk disease of the neck
- Diabetes
- Hyperthyroidism
- Hypothyroidism
- Parkinson's disease
- Stroke
The exact reason why these conditions increase the risk of frozen shoulder is not fully understood, but it is believed that they may cause changes within the shoulder capsule that lead to inflammation and scarring.
Other causes of frozen shoulder
- Age: Frozen shoulder is more common in people over the age of 40, so age can also be a risk factor
- Gender: Women are more likely to develop frozen shoulder than men
- Immobilisation: People who have a shoulder immobilised for a prolonged period of time, such as following a fracture or surgery, have a higher risk of developing frozen shoulder
To diagnose your frozen shoulder, your consultant will first ask you about your symptoms and how long you've had them before examining your shoulder.
They'll start by moving your shoulder in all directions in what's known as 'passive range of motion' to see how your shoulder moves, whether your movement is limited and if your shoulder is causing you any pain. Next, they'll ask you to move your shoulder by yourself, comparing the way your shoulder moves in active range of motion. If you have a frozen shoulder, your consultant will notice limited range of motion in both active and passive range of motion.
To rule out other potential causes, your consultant may order one or more of the following tests:
- X-ray
- Magnetic resonance imaging (MRI)
- Ultrasound
These tests allow your consultant to take a closer look at your shoulder to see any potential problems you may have, such as shoulder arthritis, and if you have any other soft tissue injuries in your shoulder, such as rotator cuff injury.
The goal of treatment for frozen shoulder is to reduce pain and improve range of motion. There are different treatment options available for frozen shoulder, including non-surgical and surgical treatments.
Non-surgical treatment options for frozen shoulder include:
Physiotherapy
Physiotherapy is often the first line of treatment for frozen shoulder. A physiotherapist will work with you to develop an exercise programme tailored to your specific needs. This may include a range of motion exercises, stretches and strengthening exercises to help improve your flexibility, strength, and function. Your therapist may also use modalities such as ultrasound, TENS, or heat/cold therapy to help manage pain and improve your range of motion.
Your physiotherapist may also recommend manual therapy, such as manipulation, mobilisations and soft tissue massage.
Medications
Over-the-counter pain relievers, such as ibuprofen or naproxen, can help to reduce pain and inflammation. Sometimes, a stronger prescription medication may be needed. Your doctor may also recommend a local anaesthetic or corticosteroid injection to help reduce inflammation and pain.
Steroid injections
Otherwise known as corticosteroids, steroid injections can be used to reduce inflammation and frozen shoulder pain. These injections can be given directly into the shoulder joint or into the soft tissue around the shoulder. Steroid injections can provide significant relief from symptoms, yet the effects are usually temporary and may need to be repeated.
Exercises for frozen shoulder
Exercises can be an effective way to improve the range of motion and reduce frozen shoulder pain. A physiotherapist can teach you exercises to help improve your range of motion and strengthen the muscles that support your shoulder. These exercises are usually done in a step-by-step progression and will be gradually increased in intensity and complexity as the shoulder improves.
Complementary therapies
Other therapies, such as acupuncture or massage, may also be beneficial in managing pain, reducing inflammation and improving range of motion. Consult with your doctor before trying any other alternative treatment options.
In rare cases, you may need surgery to remove scar tissue or loosen the capsule around the shoulder joint. We typically consider surgery for a frozen shoulder when non-surgical treatments have not provided significant improvement in symptoms.
Types of shoulder surgery that might help correct a frozen shoulder include:
Manipulation under anaesthesia (MUA)
Manipulation under anaesthesia (MUA) is a procedure that is performed under general anaesthesia, where your shoulder joint is manipulated to help improve the range of motion. Your consultant may use this procedure if your shoulder is severely stiff and has not responded to other treatments.
Shoulder arthroscopy
A shoulder arthroscopy is a minimally invasive (keyhole) surgical procedure that uses a small camera to view the inside of the shoulder joint. The surgeon can then use small instruments to remove any scar tissue or adhesions that are causing the restriction in motion. This procedure may be performed under local anaesthesia or general anaesthesia and it has a relatively short recovery time.
It's important to note that recovery from a frozen shoulder can take time, and it may take several months before you notice a significant improvement in your symptoms. However, with the right treatment and consistent follow-up, most people are able to regain a significant amount of movement and function in their shoulder.
At Circle Health Group, we understand that a diagnosis of frozen shoulder can be worrying, and the thought of seeking treatment can be daunting. That's why we strive to make the process as easy and stress-free as possible, starting with your initial consultation.
Why your first consultation so important
Your first consultation is critical in the diagnosis and treatment of frozen shoulder. During this visit, we will work with you to understand your symptoms and perform a thorough examination of your shoulder. This information will be used to develop a personalised treatment plan that is tailored to your specific needs.
The earlier that we can diagnose and start treating your frozen shoulder, the more effective the treatment will be in terms of reducing pain, improving your range of motion, and helping you return to your normal activities as soon as possible.
How we decide what treatment is best for you
Based on the information gathered during your initial consultation, our specialists will work with you to develop a personalised treatment plan, taking into account your symptoms, medical history, and overall health and wellness goals.
The treatment plan may include a combination of non-surgical and surgical options, such as physiotherapy, medication, steroid injections, and manipulation under anaesthesia. Our specialists will also continuously monitor your progress and adjust the treatment plan as needed to ensure that you are receiving the best care possible.
If you have been diagnosed with frozen shoulder, you may have many questions about your condition, its treatment, and how to manage your symptoms. In this FAQ section, we will answer some of the most common questions about frozen shoulder.
How to cure frozen shoulder quickly
Many people want to know if there is a way to cure frozen shoulder quickly. Unfortunately, there is no one-size-fits-all answer to this question. The recovery time for frozen shoulder can vary depending on the severity of the condition and the specific treatment plan that is used.
Physiotherapy and range of motion exercises are often considered first-line treatments for frozen shoulder and can help to improve range of motion and reduce pain over time.
Medications, such as non-steroidal anti-inflammatory drugs, can also help to reduce pain and inflammation.
Steroid injections can provide relief from pain and inflammation, but the effects are usually temporary and may need to be repeated.
In rare cases, surgery may be necessary to remove scar tissue or loosen the capsule around the shoulder joint.
However, treatment choices depend on your condition and the cause of the frozen shoulder, so the best course of action is to consult with our specialists to create a personalised treatment plan.
How to sleep with a frozen shoulder?
Sleeping with a frozen shoulder can be challenging, as the pain and stiffness can make it difficult to find a comfortable position.
A supportive pillow or foam wedge can elevate the shoulder and keep it in a neutral position while sleeping.
You can also try sleeping on the unaffected shoulder or placing a small pillow between your arm and body to help keep the shoulder in a comfortable position.
It may also be helpful to use a heating pad before going to bed to help relax the shoulder muscles and reduce pain.
What is frozen shoulder pain like?
Frozen shoulder pain can vary from person to person, but it is typically described as a dull or achy pain that is concentrated in the shoulder and may radiate down the arm.
Pain may be worse with movement and can make it difficult to perform daily activities such as dressing, reaching overhead, or brushing your hair.
The shoulder may also feel stiff and have a limited range of motion.
What are the dos and don'ts for frozen shoulder?
- DO engage in physiotherapy and exercises as prescribed by a physiotherapist or your doctor to improve your range of motion and strengthen the shoulder
- DO use heat or cold therapy to manage pain as recommended by your doctor
- DO take over-the-counter pain medication as directed
- DON'T engage in activities that cause pain or discomfort, such as lifting heavy objects or taking part in contact sports
- DON'T ignore your symptoms or put off seeking treatment. The sooner you start treatment, the better your chances of recovery
What is the best treatment for frozen shoulder?
The best treatment for a frozen shoulder will depend on the specific case, but we often consider physiotherapy and range of motion exercises first-line treatments.
Medications, such as non-steroidal anti-inflammatory drugs, can also help to reduce pain and inflammation.
Steroid injections and manipulation under anaesthesia may be used for more severe cases.
In rare cases, surgery may be necessary to remove scar tissue or loosen the capsule around the shoulder joint.
Can you drive with a frozen shoulder?
It depends on the severity of the frozen shoulder and your ability to control the vehicle safely. If you are experiencing significant pain and decreased range of motion in the shoulder, it may be difficult to drive safely.
It's best to check with your consultant or physiotherapist for guidance on whether it is safe for you to drive with your particular symptoms. Sometimes, modifications to the vehicle, such as special mirror adjustment or specially designed steering wheel knobs, could make it easier to drive with a frozen shoulder.
If your consultant or physiotherapist says it's safe to drive, be sure to take any prescribed medication before driving and make any necessary adjustments to your vehicle to help ensure your safety while driving. You should also speak to your insurance company to make sure you are covered.
When you choose to go private with Circle Health Group, you can expect:
- Flexible appointment times and locations to suit your routine
- The freedom to choose which hospital and consultant fit your needs
- Personalised, consultant-led treatment plans tailored to your specific requirements
- Comfortable and safe private facilities maintained by expert multidisciplinary teams
- Private cosy ensuite rooms as standard and delicious healthy meals
- Affordable, fixed-price packages with aftercare included
- Flexible payment options to help you spread the cost of your care
If you would like to learn more about treatment for frozen shoulder, book your appointment online or call a member of our team today.
Content reviewed by Circle in-house team in January 2023. Next review due January 2026.
- Frozen shoulder, NHS
- Frozen shoulder, Mayo Clinic
- Frozen shoulder, OrthoInfo
- How to release a frozen shoulder, Harvard Health
- Frozen shoulder, John Hopkins Medicine
- Frozen shoulder, Bupa
- Frozen shoulder, NIH
- What is a frozen shoulder?, WebMD
