What is frozen shoulder?
Frozen shoulder (adhesive capsulitis) occurs when the capsule surrounding the shoulder joint becomes inflamed, thickened and tight. It typically affects people between 40 and 65, is more common in those with diabetes or thyroid conditions, and can follow minor injury or surgery — or appear out of the blue.
The typical course
Frozen shoulder usually moves through three overlapping phases over 1–3 years:
- Freezing — increasing pain, especially at night, with progressive stiffness
- Frozen — pain eases but the shoulder remains very stiff; reaching overhead, behind the back and out to the side is limited
- Thawing — movement gradually returns
Most frozen shoulders eventually recover, but the timeline can be long and the disability significant — treatment aims to shorten it.
Non-surgical treatment
- Education and reassurance — understanding the natural course matters
- Corticosteroid injection into the joint, most effective in the painful early phase
- Hydrodilatation — injection of fluid under pressure to stretch the capsule
- Gentle physiotherapy within comfort; aggressive stretching in the painful phase tends to backfire
Arthroscopic capsular release
For shoulders that remain severely stiff despite time and the measures above, keyhole surgery can divide the thickened capsule and restore movement.
- Day surgery or overnight stay
- Movement begins immediately after surgery — early physiotherapy is essential
- Most patients gain substantial improvement in motion and comfort over the following weeks
When to seek review
Night pain and progressive stiffness deserve assessment — frozen shoulder is frequently confused with rotator cuff problems and arthritis, and an X-ray is needed to exclude other causes of a stiff shoulder.