Quick answer
What is frozen shoulder?
Frozen shoulder (adhesive capsulitis) is stiffness and pain in the shoulder joint that develops gradually and can last 1 to 3 years. It often follows injury or immobility and is more common in people with diabetes. Treatment includes pain relief, physiotherapy and sometimes injections — most people recover fully but it takes time.
What is frozen shoulder?
Frozen shoulder — adhesive capsulitis — is a condition where the shoulder joint capsule (the connective tissue surrounding the joint) thickens and tightens, causing pain and progressive stiffness. It usually develops gradually, often without obvious injury, and typically resolves over 18 months to three years — though the timeline varies.
It most commonly affects people aged 40 to 60, and is more frequent in women and people with diabetes.
Symptoms
Frozen shoulder develops in stages:
Stage 1 — Freezing (2 to 9 months):
- increasing pain, especially at night
- pain with any shoulder movement
- stiffness beginning to develop
Stage 2 — Frozen (4 to 12 months):
- pain may lessen but stiffness is severe
- markedly reduced range of movement
- difficulty with daily tasks — dressing, reaching overhead, brushing hair
Stage 3 — Thawing (6 months to 2 years):
- gradual return of movement
- pain continues to improve
The whole process can be frustratingly slow, but most people recover fully.
Causes and risk factors
Often no single cause is identified. Known associations include:
- previous shoulder injury or surgery
- prolonged immobilisation — arm in a sling
- type 2 diabetes — significantly higher risk
- thyroid disease
- heart disease and Parkinson’s disease
- age and sex — more common in women over 40
Diagnosis
A GP or physiotherapist diagnoses frozen shoulder from symptoms and examination — checking range of movement actively and passively. Imaging (X-ray or ultrasound) may rule out arthritis or rotator cuff tears.
Treatment
Treatment focuses on pain relief and restoring movement:
Pain relief:
- paracetamol and ibuprofen
- avoiding movements that cause sharp pain, but not stopping all movement
Physiotherapy:
- gentle stretching and range-of-movement exercises
- a physiotherapist guides safe progression — forced aggressive stretching can worsen symptoms
Injections:
- corticosteroid injection into the joint for severe pain, especially in the freezing stage
Surgery:
- rarely needed — arthroscopic capsular release or manipulation under anaesthetic for persistent severe cases
Living with frozen shoulder
Frozen shoulder tests patience. Tips for daily life:
- sleep with the affected arm supported on pillows
- use the arm for light activities within comfortable limits
- adapt tasks — a long-handled sponge, front-fastening clothes
- stay active within pain limits — complete immobilisation worsens stiffness
Frozen shoulder vs other shoulder problems
Rotator cuff injury — pain with specific movements but less global stiffness. Osteoarthritis — older age, gradual wear-and-tear pain. Neck problems — can refer pain to the shoulder. Proper assessment ensures correct treatment.
When to see a GP
See a GP for progressive shoulder stiffness and pain affecting daily life. Early physiotherapy referral may shorten recovery. Seek urgent help for sudden severe pain after trauma, fever with a hot swollen joint, or neurological symptoms in the arm.
Common questions
- What are the symptoms of frozen shoulder?
- Gradually worsening shoulder pain, especially at night and when lying on the affected side, followed by increasing stiffness and reduced range of movement — difficulty reaching behind your back, overhead, or across your body.
- What causes frozen shoulder?
- The shoulder joint capsule thickens and tightens, restricting movement. Often no clear cause, but it follows shoulder injury, surgery, or prolonged immobility. Diabetes, thyroid disease and heart conditions increase risk.
- How long does frozen shoulder last?
- Typically 18 months to 3 years through three stages — painful freezing, stiff frozen, then gradual thawing. Most people recover fully, though some have mild ongoing stiffness. Patience and consistent physiotherapy help.
- How is frozen shoulder treated?
- Paracetamol and ibuprofen for pain, physiotherapy to maintain and restore movement, corticosteroid injections into the joint for severe pain, and rarely surgery or manipulation under anaesthetic. Treatment depends on the stage.
- Is frozen shoulder the same as arthritis?
- No. Osteoarthritis affects the joint surfaces; frozen shoulder affects the capsule surrounding the joint. Both cause stiffness but need different management — a GP or physiotherapist distinguishes them.