What are the stages of frozen shoulder?

Frozen shoulder progresses in three stages: freezing (increasing pain and stiffness), frozen (severe stiffness with less pain), and thawing (gradual return of motion).

How long does frozen shoulder last?

Frozen shoulder may last 12–24 months without treatment. With physiotherapy and injections, symptoms often improve faster.

How is frozen shoulder treated?

Treatment includes physiotherapy, anti-inflammatory medication, corticosteroid injections, hydrodilatation, and in some cases arthroscopic capsular release or manipulation under anaesthetic.

Who is at risk of frozen shoulder?

Risk factors include age 40–70, diabetes, thyroid disease, previous shoulder injury or surgery, and prolonged shoulder immobility.

Frozen Shoulder (Adhesive Capsulitis):
Symptoms, Stages & Treatment

Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain, stiffness, and loss of movement in the shoulder joint. It develops when the capsule surrounding the shoulder joint thickens and tightens, restricting motion. With the right treatment, most patients gradually regain mobility and function.

What Is Frozen Shoulder?

The shoulder joint is surrounded by a capsule of connective tissue. In frozen shoulder, this capsule becomes inflamed and stiff, leading to painful restriction of movement. The condition often develops gradually and may last many months if untreated.

Symptoms of Frozen Shoulder

Dull or aching pain, often worse at night
Stiffness and difficulty moving the shoulder
Reduced ability to reach overhead, behind the back, or across the body
Gradual loss of both active and passive range of motion

The Three Stages of Frozen Shoulder

Freezing stage (2–9 months): Increasing pain and stiffness, movement becomes limited.
Frozen stage (4–12 months): Pain may improve, but stiffness remains significant.
Thawing stage (6–24 months): Shoulder gradually regains motion and function.

Causes and Risk Factors

The exact cause is not always clear, but frozen shoulder is more common in:

People aged 40–70
Those with diabetes or thyroid disorders
After shoulder injury or surgery (due to reduced movement)
People with prolonged shoulder immobility (e.g. after fracture or illness)
Women (slightly higher risk than men)

How Is Frozen Shoulder Diagnosed?

Diagnosis is based on history and examination, showing restriction in all directions of shoulder movement. Imaging may be used to rule out other conditions:

X-rays: To exclude arthritis or bone problems
MRI or ultrasound: To check for rotator cuff tears or inflammation

Treatment Options

Non-Surgical Management

Pain relief with anti-inflammatory medication (NSAIDs)
Physiotherapy to maintain movement and reduce stiffness
Corticosteroid injections to reduce pain and inflammation
Hydrodilatation (saline injection into the joint to stretch the capsule)

Surgical Treatment

If symptoms do not improve with non-surgical methods, surgery may be considered:

Arthroscopic capsular release: Keyhole surgery to release the tightened capsule
Manipulation under anaesthetic: The shoulder is gently stretched while asleep to restore motion

Recovery and Prognosis

Frozen shoulder often improves gradually over time, but treatment speeds recovery and reduces pain. Most patients recover full or near-full function, though stiffness may persist in some cases.

Return to desk work: Often possible within 1–2 weeks with pain control
Physiotherapy: Continues for several months
Full recovery: Typically 6–24 months, depending on stage and treatment

When to See a Shoulder Specialist

If shoulder pain and stiffness persist for weeks and affect sleep or daily activities, it is important to consult a shoulder specialist. Early intervention improves comfort and speeds recovery.