What is frozen shoulder?
Frozen shoulder (adhesive capsulitis) is a condition in which the capsule surrounding the shoulder joint becomes inflamed, thickened and tight. As it contracts, the shoulder becomes progressively stiff and painful, limiting movement in every direction.
It typically develops without an obvious cause, though it is more common after a period of immobility and in people with diabetes or thyroid conditions. Characteristically, it moves through distinct phases and tends to resolve over time, even if slowly.
The three phases
Pain dominates
Increasing pain, often worse at night, with movement gradually becoming more limited. Lasts roughly 2–9 months.
Stiffness dominates
Pain may ease, but stiffness is marked and daily tasks are restricted. Lasts roughly 4–12 months.
Motion returns
Movement slowly and steadily improves, often back to near-normal over the following months.
Signs and symptoms
- checkProgressive stiffness limiting movement in all directions.
- checkA deep, aching pain often worse at night and on sudden movement.
- checkDifficulty with everyday tasks reaching overhead, dressing, fastening a seatbelt.
- checkA loss of both active and passive motion even when someone else moves the arm.
How it is diagnosed
Frozen shoulder is largely a clinical diagnosis — the hallmark is loss of both active and passive movement, which distinguishes it from a cuff tear. Imaging such as X-ray or MRI is mainly used to exclude other causes of a stiff, painful shoulder.
Treatment options
Treatment is matched to the phase, focusing first on controlling pain, then on restoring motion.
Physiotherapy
Gentle, progressive stretching maintains and then restores range of motion as pain allows.
Pain control & injection
Anti-inflammatories and a well-timed injection can settle the painful phase and unlock progress.
Release procedures
For stubborn cases, manipulation under anaesthetic or an arthroscopic capsular release restores movement.
Recovery & outlook
The reassuring message is that frozen shoulder almost always improves, with most patients regaining good, functional movement. The course can be long — sometimes a couple of years — but a clear, phase-based plan eases symptoms and can meaningfully shorten the journey.