Advice and information for patients

Frozen shoulder (also known as adhesive capsulitis) is a condition where the lining of the shoulder joint (capsule) becomes contracted and inflamed causing pain and loss of movement. It is one of the more painful shoulder conditions, especially in the early stages, and can therefore cause sleep disturbance and loss of function.

What are the symptoms of frozen shoulder?

The two main clinical features of frozen shoulder are pain and stiffness. The main symptoms of frozen shoulder include:

  • Pain: There is often a constant toothache pain at rest with sharper pain on movement. The pain may be severe enough to affect your sleep
  • Stiffness: Global restriction of shoulder movement, more markedly shoulder elevation (reaching up) and rotation (turning your arm away from your body)

Three stages of frozen shoulder exist:

  1. The freezing stage: The shoulder starts to become painful and movements become more restricted. Pain is often worse at night. This stage may last from two to nine months.

  2. The frozen stage: Pain levels start to decrease, however the shoulder may become very stiff and movement limited. This stage may last from four to 12 months.

  3. The thawing stage: The condition starts to resolve. Pain continues to fade and shoulder movement starts to improve over a number of months or even years.

What causes frozen shoulder?

The exact cause of frozen shoulder is unknown. Symptoms can develop out the blue but can also be triggered following injury or surgery to the shoulder. Evidence shows that if you suffer from other health complaints, such as diabetes, high cholesterol and heart disease that you are more likely to develop frozen shoulder.

The condition typically affects women more than men and is more common in people from 40 years old onwards.

How is it diagnosed?

Diagnosis is usually made from the patient's history and an examination, without the need for special investigations. An x-ray may be performed, but this is unusual for frozen shoulder.

How can I manage my frozen shoulder?

Most frozen shoulders naturally recover over a two to four year period after onset. However the pain and limitations experienced due to frozen shoulder often require treatment which commonly includes shoulder mobility exercises and stretches to maintain or regain movement.

Painkillers such as paracetamol and ibuprofen may help and you should use them if you need to. A steroid injection may be offered in the earlier stage of a frozen shoulder to reduce pain and inflammation.

Activity modification can also help. This simply means trying to keep the shoulder moving within the limits of your pain.

Further management options

If you feel you need further support with managing your problem after following the self-management information above, please seek further advice from your physiotherapist or GP.