Frozen shoulder runs through recognisable stages, and the treatment that helps in one stage is the treatment that aggravates another. Getting the stage right matters most.
Frozen shoulder, or adhesive capsulitis, is a thickening and contraction of the joint capsule that produces severe pain and progressive loss of movement in every direction. It is most common between 40 and 60, more common in women, and considerably more common in people with diabetes or thyroid conditions.
It classically moves through a painful freezing stage, a stiff frozen stage where the pain eases, and a thawing stage where range gradually returns. The whole course commonly runs one to three years, and it usually resolves substantially even without treatment, though few people are willing to wait that out unaided.
Common symptoms:
Treatment is matched to the stage. Forcing range in the painful freezing stage tends to inflame the shoulder further and set progress back, so early care focuses on pain control, sleep, gentle movement within comfort, and keeping the rest of the arm working.
Once pain settles into the stiff stage, sustained mobility work and loading through the available range become productive. Where pain stays severe and sleep is badly affected early on, an intra-articular corticosteroid injection has reasonable evidence for short-term relief and can make rehabilitation possible, so we discuss referral for one where it fits.
The right treatment depends entirely on which stage the shoulder is in.
We confirm the diagnosis by testing passive range in every direction, rule out cuff problems and referred neck pain, and establish which stage you are in.
Sleep positioning, pain management, gentle pain-free movement and maintaining elbow, wrist and neck function, with onward referral for injection where pain is severe.
Sustained stretching and mobility work at end of range, done frequently, alongside loading through whatever range is available.
As range returns we rebuild strength and take the shoulder back to overhead tasks, work and sport.
Not sure whether your shoulder is frozen or a cuff problem? Book a free discovery call and we will talk through what you are experiencing.
Book a Free Discovery CallCommonly one to three years from onset to substantial recovery, though a proportion of people are left with some loss of range. Stage-appropriate treatment tends to make the course more tolerable and the outcome better.
In the painful freezing stage, forcing range typically flares the shoulder and sets progress back. Sustained stretching becomes useful later, once pain has settled and stiffness is the main problem.
There is reasonable evidence for short-term pain relief from an intra-articular corticosteroid injection in the early painful stage, and it often makes rehabilitation possible when night pain is severe.
Yes. It is considerably more common in people with diabetes, often more severe, and can affect both shoulders in turn.
Most cases resolve without it. Manipulation under anaesthetic or capsular release is considered for shoulders that stay stiff and disabling well beyond the expected course.
It can, in a meaningful proportion of people, usually after the first has recovered. It rarely recurs in the same shoulder.
Book a thorough assessment in Uckfield and we will confirm the diagnosis, work out the stage and treat it accordingly.
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