| What We Treat
Frozen Shoulder
Struggling to reach behind your back, sleep on your side, or lift your arm overhead? Frozen shoulder can feel alarming when it sets in, but it’s a well-understood condition with a predictable pattern — and the right support can ease the pain and help you move through it faster.
Overview
What Is Frozen Shoulder?
Frozen shoulder (also called adhesive capsulitis) happens when the capsule surrounding the shoulder joint becomes thickened and tight, restricting movement in several directions at once — not just the one that hurts most. It typically affects people between 40 and 60, is more common in women, and is strongly linked to diabetes. It usually resolves without surgery, though it can take one to three years to run its full course.
The shaded wedge shows roughly how much shoulder movement is available in each phase.
1. Freezing (0–9 months)
Pain gradually worsens, often disturbing sleep, while movement becomes progressively more limited.
2. Frozen (4–12 months)
Pain settles somewhat, but stiffness dominates — everyday tasks like dressing or reaching become difficult.
3. Thawing (6–24 months)
Movement gradually returns, though full recovery can take time and some stiffness may persist.
Symptoms
How It Tends to Feel
Frozen shoulder has a fairly distinctive pattern that sets it apart from other shoulder problems:
Global Stiffness
Loss of movement in multiple directions — not just reaching overhead, but also rotating the arm outward and reaching behind your back.
Deep, Aching Pain
Often felt deep in the shoulder and upper arm, particularly during the freezing phase, and frequently worse at night.
Disturbed Sleep
Difficulty finding a comfortable position, especially lying on the affected side, is one of the most common complaints.
Difficulty With Daily Tasks
Reaching behind your back, fastening a bra, reaching for a seatbelt, or putting on a coat can all become noticeably harder.
Gradual Onset
Unlike an injury, symptoms tend to build over weeks rather than appearing suddenly after a specific incident.
Slow, Steady Change
The condition moves through recognisable phases over months rather than staying the same — useful for tracking progress.
Causes & Risk Factors
What Drives It
In most cases there’s no single injury behind frozen shoulder — it develops gradually, and certain factors make it more likely.
Primary (Idiopathic) Frozen Shoulder
The most common presentation, where the capsule thickens and tightens without any clear triggering event.
Diabetes
People with diabetes are significantly more likely to develop frozen shoulder, and it can be more severe, affect both shoulders, and take longer to resolve.
Thyroid Disease
Both underactive and overactive thyroid conditions are associated with an increased risk.
Secondary Frozen Shoulder
Can follow a period of reduced shoulder movement — for example after an injury, surgery, or immobilisation in a sling.
Age & Sex
Most common between the ages of 40 and 60, and more frequently seen in women.
How We Can Help You
Treatment & Management
Frozen shoulder tends to improve with time, but that doesn’t mean you have to just wait it out. The right approach at each phase can ease pain, protect your sleep, and help you keep — or regain — as much movement as possible along the way.
What the evidence says
The UK FROST trial — the largest randomised trial of its kind, run across 35 NHS hospitals — compared early structured physiotherapy with a steroid injection against two surgical options (manipulation under anaesthetic and arthroscopic capsular release). At 12 months, neither operation produced a clinically important advantage over physiotherapy, and capsular release carried the highest risk of complications.
That’s a genuinely useful finding: for most people, a well-delivered physiotherapy programme is a reasonable first choice, and surgery is something to consider if that route doesn’t work — not something you’ve missed out on by starting conservatively.
When to Seek Help
Red Flags — Don’t Ignore These
Frozen shoulder itself is not an emergency and doesn’t need urgent treatment. But shoulder pain occasionally has a different, more serious cause. Contact your GP promptly — or call 999 or attend A&E for the emergency signs marked below — if you notice:
⚠ Seek prompt medical assessment if you notice:
- A hot, red, swollen joint with fever or feeling generally unwell (possible joint infection — seek emergency care)
- Chest pain, breathlessness, or pain spreading to the jaw or down the arm alongside shoulder pain (possible cardiac cause — call 999)
- Significant trauma followed by inability to move the arm, or an obvious deformity (possible fracture or dislocation)
- Unexplained lump, swelling, or muscle wasting around the shoulder
- Constant, unrelenting night pain unrelated to position or movement, especially with unexplained weight loss or a history of cancer
These symptoms can indicate a cause other than frozen shoulder that needs prompt medical attention. Please don’t wait for a physiotherapy appointment — contact your GP, call 999, or attend A&E as appropriate.
Common Questions
Frequently Asked Questions
How long does frozen shoulder actually last?
Most cases run their course in one to three years, though this varies widely. The freezing phase is usually the most painful, the frozen phase the most limiting, and the thawing phase the most encouraging. Good management won’t always shorten the overall timeline dramatically, but it reliably makes the journey more comfortable and protects the movement you have.
Will stretching make it worse?
Aggressive, into-pain stretching during the painful freezing phase tends to flare symptoms without speeding recovery. Gentle, frequent movement within a tolerable range is far more productive early on, with more assertive stretching introduced as the pain settles. That phase-matching is a large part of what physiotherapy adds.
Should I have a steroid injection?
Injections tend to be most useful in the earlier, more painful phase, where they can meaningfully reduce pain and make exercise possible. They work best combined with a structured exercise programme rather than on their own. It’s a shared decision, and one worth talking through — whether the timing is right for you.
Can it happen in the other shoulder too?
It can. Around one in five people go on to develop it in the opposite shoulder, usually not at the same time. It’s more common in people with diabetes. Having had it once doesn’t make it inevitable, and recurrence in the same shoulder is unusual.
Ready to Start Moving Freely Again?
Your physio will confirm what phase you’re in, ease your pain, and build a plan that helps you keep moving through recovery — not just wait it out.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.