Frozen Shoulder: Why It Happens and How to Treat It Faster

If you’ve found yourself unable to raise your arm, reach behind your back, or sleep comfortably on one side, you might be facing more than just shoulder stiffness—you could be dealing with frozen shoulder, also known as adhesive capsulitis.

This condition is frustratingly slow to resolve and often misunderstood. Many patients are told to “wait it out” or are misdiagnosed with rotator cuff problems or arthritis. But with the right diagnosis and a structured approach, recovery can be significantly accelerated.

At MSK Doctors, we believe in active, personalised treatment—not passively waiting a year or more for your shoulder to “thaw.” Whether you're in the early painful stage or struggling with long-term stiffness, modern care can help you regain your movement and your life.

What Is Frozen Shoulder?

Frozen shoulder is a progressive inflammatory condition affecting the capsule of the shoulder joint. The capsule becomes thickened, tight, and scarred, severely limiting motion and causing pain.

It typically affects adults between 40 and 65 years old, and is more common in women and people with certain metabolic conditions like diabetes or thyroid dysfunction. It can occur spontaneously (idiopathic), after an injury, or following surgery or immobilisation.

The Three Stages of Frozen Shoulder

Freezing Stage (Painful Phase)
- Increasing pain, especially at night
- Motion becomes more limited over weeks to months
- Inflammation is active
Frozen Stage (Stiff Phase)
- Pain may decrease, but stiffness dominates
- Daily activities become difficult (dressing, reaching, driving)
- Lasts 4–12 months without treatment
Thawing Stage (Recovery Phase)
- Slow return of mobility
- Can take 6–24 months to fully resolve naturally
- Often incomplete without intervention

Without guidance, frozen shoulder can linger for 2 years or more, and some patients never regain full range of motion.

Common Symptoms

Sudden or gradual onset of shoulder pain
Pain at night or when lying on the affected side
Stiffness when reaching overhead, behind the back, or to the side
Weakness due to pain, not muscle damage
Difficulty with everyday tasks like dressing or fastening a bra

Diagnosis is typically made through clinical examination and imaging, such as onMRI™ or ultrasound, to rule out rotator cuff tears or joint arthritis.

What Causes Frozen Shoulder?

While the exact mechanism isn’t fully understood, frozen shoulder results from inflammation and fibrosis of the joint capsule. Risk factors include:

Age (most common between 40–65)
Female sex
Diabetes or thyroid disease
History of shoulder injury or surgery
Prolonged immobilisation (e.g. after fracture or rotator cuff tear)

It’s important to differentiate frozen shoulder from rotator cuff injury, osteoarthritis, or referred neck pain, as the treatments are very different.

Modern Treatments: Speed Up Your Recovery

At MSK Doctors, we offer a structured, multi-modal approach to frozen shoulder that targets inflammation, capsular restriction, and movement retraining.

✅ Hydrodilatation (Guided Capsule Release)

A game-changing, non-surgical procedure involving the injection of saline and anti-inflammatory medication into the joint capsule under ultrasound or onMRI™ guidance. It helps:

Expand the tight capsule
Reduce inflammation
Improve range of motion within weeks

✅ Cryo-Ultrasound Therapy

Combines cold and ultrasound energy to reduce inflammation, support healing, and ease pain—especially during the painful early stage.

✅ Targeted Physiotherapy

Not all exercises are appropriate in frozen shoulder. Our guided rehab includes:

Capsule-specific mobilisation
Scapular control and postural retraining
Range-preserving techniques based on phase of recovery
MAI-Motion™ analysis to track movement deficits and progress

✅ Pain Management Support

Injections (e.g. corticosteroids or biologics) may be used selectively in early stages to calm pain and allow rehab to proceed.

Why "Waiting It Out" Isn’t Always the Best Plan

While frozen shoulder can resolve spontaneously, doing nothing may prolong recovery and increase the risk of incomplete return to function.

Long-term stiffness can become permanent
Sleep quality and mood may suffer
Compensation may affect the opposite shoulder or neck
It may impact driving, work, and independence

Early diagnosis and active treatment can significantly reduce recovery time and prevent long-term disability.

Frequently Asked Questions (FAQs)

1. How do I know if I have frozen shoulder?
Gradual stiffness, reduced range of motion in all directions, and shoulder pain (especially at night) are key signs. An assessment and scan confirm the diagnosis.

2. Can frozen shoulder heal on its own?
Yes, but it may take up to 2 years. Without intervention, you may be left with long-term stiffness or incomplete recovery.

3. What is hydrodilatation, and is it painful?
Hydrodilatation is a non-surgical injection procedure that expands the joint capsule. It’s quick, safe, and generally well tolerated with local anaesthetic.

4. When is surgery needed?
Surgery (capsular release) is rare and usually reserved for cases not responding to other treatments after 6–12 months.

5. Is physiotherapy helpful in the early painful phase?
Gentle mobility exercises can be helpful. Aggressive stretching too early may worsen pain and inflammation—timing is key.

6. Can frozen shoulder come back?
Recurrence is rare but can happen, especially in the opposite shoulder. Managing risk factors (e.g. diabetes, immobilisation) helps prevent it.

Conclusion: Don’t Let Frozen Shoulder Freeze Your Life

Frozen shoulder doesn’t have to be a multi-year struggle. With expert care, accurate diagnosis, and modern therapies like hydrodilatation, cryo-ultrasound, and motion-guided rehab, recovery can be faster, more complete, and far less frustrating.

At MSK Doctors, we use precision diagnostics and a multidisciplinary approach to treat the cause—not just the symptoms—of shoulder stiffness. No GP referral needed.

Ready to unfreeze your shoulder? Book a personalised assessment today.