Frozen Shoulder: Stages, Treatment and What to Expect

What Is Frozen Shoulder?

Frozen shoulder, medically called adhesive capsulitis, is a condition in which the shoulder becomes painful and progressively stiff. The capsule surrounding the joint becomes inflamed and tight, limiting movement in all directions, including when someone else tries to move the arm. The exact cause is often unclear, although it is more common in people with diabetes, thyroid conditions and after a period of immobility, and it tends to affect people in middle age.

Physiotherapy assessment at JW Physio Clinic in Loughton for shoulder and joint problems — JW Physio Clinic, Ambrose House, Old Station Road, Loughton

The Three Stages

Frozen shoulder is usually described in three overlapping stages, though timings differ between people:

Freezing: pain gradually increases, often worse at night, and movement starts to reduce
Frozen: pain may ease a little, but stiffness is marked and everyday tasks become difficult
Thawing: movement gradually returns, and pain settles

The whole process often takes many months and can last a year or two, although most people recover a good level of function.

How Is It Different From Other Shoulder Problems?

Rotator cuff problems and impingement usually cause pain with certain movements, while frozen shoulder typically limits movement in every direction, including passive movement. Because these conditions can look similar early on, a proper assessment is important.

What Can Help?

Treatment depends on the stage and how severe your symptoms are:

Education about the condition and what to expect, which in itself reduces worry
Gentle exercises within comfort, matched to the stage you are in
Hands-on treatment to ease pain and maintain movement
Pain relief advice, including speaking to your GP or pharmacist about medication
Steroid injection, which may help pain in some people and can be done under ultrasound guidance
Other options such as hydrodilatation or surgery are sometimes considered for severe, persistent cases, and your GP or a specialist can advise

What to Avoid

Forcing the shoulder through severe pain, especially in the early painful stage, can make symptoms worse. Complete immobilisation is also not helpful. Gentle, regular movement within comfort is usually the better approach.

Sleeping and Daily Life

Night pain is common. Many people find it easier to sleep with a pillow supporting the arm or by lying on the unaffected side. Plan tasks so the affected arm does not have to do too much, and take frequent short breaks.

When to Get Help

If your shoulder is becoming steadily stiffer and more painful, or you cannot lift your arm, an assessment will clarify the diagnosis and the best approach. Seek urgent help for sudden severe pain after a fall, chest pain or pain with shortness of breath.

Exercises You May Be Given

Exercise advice should match the stage you are in. In the early painful stage, gentle movements such as pendulum swings and assisted arm raises within comfort are common. As the shoulder stiffens, stretches and mobility work are introduced carefully. In the thawing phase, strengthening becomes more important to restore function. Doing little and often is usually better than occasional hard sessions.

Why Diabetes and Thyroid Conditions Matter

Frozen shoulder occurs more often in people with diabetes and some thyroid conditions. If you have either, mention it at your assessment, and speak to your GP if your shoulder symptoms are affecting your sleep or daily life. Good management of the underlying condition is part of looking after yourself.

Looking After Your Mood and Sleep

Frozen shoulder is long and uncomfortable, and broken sleep can make pain feel worse. Small steps help: positioning pillows, taking pain relief as advised by your GP or pharmacist, pacing your day and staying in touch with friends and activities you enjoy. If you feel very low or exhausted, tell your GP.

Frequently Asked Questions

It commonly lasts many months and can take a year or two to resolve, although most people regain good movement.

Physiotherapy cannot speed up the natural process in every case, but it can help manage pain, maintain movement and guide you through the stages.

No. Forcing the shoulder, especially in the early painful stage, can make it worse. Gentle movement within comfort is usually better.

A steroid injection may help pain for some people, particularly in the earlier stages. We can discuss options and refer where appropriate.

Talk to the JW Physio Clinic team

Book an appointment at our Loughton clinic. No GP referral is needed, and same-week appointments are usually available.

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