At a glance
What it is
Inflammation and thickening of the shoulder capsule (adhesive capsulitis) causing pain and loss of movement.
Typical signs
Deep aching pain, inability to reach behind the back or overhead, worse at night.
How we treat it
Physiotherapy for range; intra-articular injection to break the pain cycle; capsular release surgery in the small stuck-solid minority.
What frozen shoulder is
Frozen shoulder — clinically, adhesive capsulitis — is an inflammatory condition in which the capsule around the shoulder joint thickens, tightens, and adheres to itself. The result is severe pain and progressive loss of movement, particularly external rotation.
The condition is self-limiting: even without treatment most cases resolve within 18 to 30 months. But that is a long time to lose a shoulder, and the point of active treatment is to shorten the runway meaningfully — often to a matter of months instead.
Three phases you go through
The condition moves through three overlapping phases. The right treatment depends on which phase you are in — pushing physiotherapy hard in the freezing phase makes pain worse and doesn't restore movement any faster.
Phase 1
Freezing (pain-dominant)
- 2–9 months. Pain is worst; movement gradually declines.
- Focus on pain control: injection, gentle mobilisation only.
- Aggressive stretching now is counter-productive.
Phase 2 & 3
Frozen → Thawing
- 4–12 months frozen; 5–24 months thawing.
- Pain reduces; stiffness is the main problem.
- Focused physiotherapy delivers most of the gain here.
What we see in clinic
2–5%
Lifetime prevalence in the general population
70%
Improve substantially within 3 months of intra-articular steroid injection
10%
Require surgical capsular release for refractory stiffness
Key facts
How it is treated
Care is phase-matched. Same interventions in the wrong order can slow you down; matched to the phase, they measurably shorten the timeline.
Pain control
Freezing phase
- Simple analgesia + short NSAID course
- Sleep positioning advice
- Intra-articular steroid injection (image-guided)
Physiotherapy
Frozen + thawing phases
- Passive range-of-motion techniques
- Capsular stretching (rotator cuff, pendulum)
- Home exercise programme, reviewed every 4–6 weeks
Injection therapy
When pain blocks progress
- Suprascapular nerve block
- Hydro-dilatation (capsular distension with saline + steroid)
- Repeat intra-articular steroid at 8–12 weeks if needed
Surgery
Small minority
- Manipulation under anaesthesia (MUA)
- Arthroscopic capsular release
- Immediate post-op physiotherapy is non-negotiable
The plan is reviewed at 6-week intervals — the phases shift, and the treatment shifts with them.
Watch the procedure
Related reading
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Widespread muscle pain that routine scans don't explain. Most of it comes from muscle and fascia, and is treatable once the source is found.
Back pain
Most back pain is mechanical and settles in weeks. The first visit identifies the few cases that need imaging, injections or surgery, without over-treating.
Book a consultation
The secretary schedules first appointments during clinic hours; please have prior imaging, operative notes and a current medication list available at the time of the call.
This page provides general information about frozen shoulder and is not a substitute for individual medical assessment. If your symptoms are severe or worsening, contact a clinician promptly.