Frozen Shoulder: What to Expect and How to Speed Up Recovery

Understanding Adhesive Capsulitis and How to Regain Movement

If you're struggling to lift your arm, reach behind your back, or perform simple overhead tasks due to pain and stiffness in your shoulder, you may be dealing with frozen shoulder, also known as adhesive capsulitis.

Frozen shoulder can be incredibly frustrating and slow to improve—but with the right treatment and a clear understanding of the condition, recovery is absolutely possible.

In this article, we’ll explain what frozen shoulder is, what to expect during recovery, and how to speed up your return to function.

What Is Frozen Shoulder?

Frozen shoulder is a condition where the shoulder joint capsule becomes inflamed, thickened, and stiff, leading to a gradual loss of motion. Over time, the soft tissues around the joint “freeze” into place, restricting normal movement.

It most commonly affects people between 40 and 60 years old and is more common in women and people with diabetes or thyroid disorders.

Causes and Risk Factors

The exact cause isn’t always clear, but frozen shoulder often follows:

• Shoulder injury or surgery

• Prolonged immobilisation (e.g. after a fracture or stroke)

• Systemic conditions like diabetes or autoimmune disorders

• In some cases, it occurs spontaneously with no obvious trigger

The 3 Phases of Frozen Shoulder

1. Freezing Phase (6–12 weeks)

• Increasing pain, especially at night

• Gradual loss of shoulder range of motion

• Difficulty with overhead or behind-the-back tasks

2. Frozen Phase (4–6 months)

• Pain may improve slightly

• Movement becomes very limited and stiff

• Everyday activities like dressing or driving become difficult

3. Thawing Phase (6–12 months or more)

• Gradual improvement in mobility

• Pain reduces significantly

• Shoulder slowly regains normal function

The total process can take 12–24 months without intervention, but appropriate treatment can accelerate recovery.

What Does It Feel Like?

• Sharp pain or deep aching in the shoulder joint

• Stiffness that restricts movement in all directions

• Pain during the night, especially when lying on the affected side

• Difficulty with everyday tasks like dressing, combing hair, or reaching overhead

Diagnosing Frozen Shoulder

Diagnosis is primarily clinical, based on:

• History of progressive stiffness and pain

• Examination of shoulder range of motion (both active and passive)

• Imaging such as X-rays or MRI may be used to rule out other causes like arthritis, rotator cuff tear, or impingement

Treatment Options: How to Speed Up Recovery

1. Physiotherapy

The cornerstone of treatment. A structured programme includes:

• Passive and active-assisted range of motion exercises

• Joint mobilisation techniques

• Postural retraining

• Strengthening once mobility improves

Consistency is key—even gentle daily stretching makes a difference.

2. Pain Management

• Oral anti-inflammatory medications (NSAIDs)

• Ice or heat application for symptom relief

• Night-time positioning advice to reduce discomfort

3. Corticosteroid Injections

Targeted injections into the joint can significantly reduce inflammation and pain, allowing better progress with physiotherapy.

4. Hydrodilatation (Capsular Distension)

An image-guided injection of saline and steroid to stretch and release the joint capsule. This can offer fast symptom relief and improve movement.

5. Manual Therapy and Modalities

• Soft tissue release or massage

• Shockwave therapy or ultrasound (as adjuncts)

• Dry needling (in selected cases)

6. Surgical Options (Last Resort)

If conservative management fails, surgical options may include:

• Manipulation under anaesthesia (MUA)

• Arthroscopic capsular release

These are typically reserved for severe or long-standing cases that don’t respond to non-surgical care.

What Can You Do at Home?

• Keep the joint as mobile as possible without causing sharp pain

• Perform gentle daily exercises as advised by your physiotherapist

• Avoid complete immobilisation—“motion is lotion”

• Apply ice or heat to manage pain and stiffness

• Use a pillow under your arm at night for support

Frequently Asked Questions (FAQ)

How long does frozen shoulder last?
Without treatment, it may last 12–24 months. With early intervention, recovery may be significantly faster—6 to 12 months in many cases.

Can frozen shoulder come back?
It rarely affects the same shoulder again but may occur in the opposite shoulder in up to 30% of patients.

Is it safe to exercise through the pain?
No. Gentle, pain-free stretching is encouraged, but forcing motion can worsen inflammation. Follow professional guidance.

Is frozen shoulder linked to other health problems?
Yes. There’s a strong association with diabetes, thyroid conditions, and postural dysfunctions.

Will I need surgery?
Most people recover with non-surgical treatments. Surgery is only considered if symptoms persist despite comprehensive therapy.

Final Thoughts

Frozen shoulder can be slow to resolve—but it’s a treatable condition. With early diagnosis, targeted physiotherapy, and supportive care, most people make a full recovery.

The key is patience, persistence, and professional guidance to restore pain-free movement and prevent long-term stiffness.

Struggling with shoulder stiffness or pain?
Get a precise diagnosis and personalised recovery plan with MSK Doctors—no referral required. Our advanced imaging and rehabilitation support can help you reclaim your shoulder function faster.