Frozen shoulder, or adhesive capsulitis, is a frustrating condition marked by pain and stiffness in the shoulder joint that can significantly limit motion.
Frozen shoulder typically unfolds in three stages, each with its own set of challenges:
Freezing Stage (several months):
Increasing pain, especially at night
Shoulder motion starts to become limited
Daily activities grow more difficult
Frozen Stage (several months):
Pain may decrease, but stiffness intensifies
Shoulder becomes increasingly difficult to move
Range of motion is restricted
Thawing Stage (6 months–2 years):
Slow improvement in shoulder movement
Pain continues to fade
Gradual return to normal function
The exact cause isn’t always clear, but it often develops after:
Shoulder injury or surgery
Prolonged immobilization (e.g., after a fracture)
Conditions like diabetes, thyroid disorders, or autoimmune diseases
Diagnosis begins with a clinical history and physical exam focused on pain levels and range of motion. A provider may try:
Passive and active range of motion tests: Noting how far you can move your arm by yourself and with assistance
Imaging:
X-rays to rule out arthritis or bone abnormalities
MRI or ultrasound in rare cases to evaluate soft tissue structures
Often the symptoms and limited movement are distinctive enough to make a confident diagnosis without excessive imaging.
Frozen shoulder typically resolves on its own, but it can take more than a year. Treatment can help relieve pain, improve range of motion, and speed up recovery.
Conservative Management (Most Common):
Physical therapy: Stretching and strengthening exercises are the cornerstone of recovery
NSAIDs: Over-the-counter meds like ibuprofen to manage pain and inflammation
Heat or cold therapy: To reduce discomfort during movement
Injections: Corticosteroids or platelet rich plasma (PRP)
Advanced or Refractory Cases:
Hydrodilatation: Injecting fluid into the joint capsule to stretch it
Manipulation under anesthesia: The shoulder is gently forced through full range while you’re sedated
Arthroscopic capsular release: Minimally invasive surgery to cut the stiffened capsule (only needed in a small percentage of patients)
Frozen shoulder can be a slow process, but with patience and guided therapy, most people recover full function over time. The key is staying proactive—starting treatment early can shorten the recovery timeline and keep you on track.