Shoulder
Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder is a stiff, painful shoulder where the joint capsule tightens. It most often affects people aged 40–60 and can last many months.
Common symptoms
- Deep, aching shoulder pain that builds over weeks
- Marked stiffness — the arm will not lift or rotate even with help
- Difficulty reaching behind your back or overhead
- Pain at night, especially lying on the affected side
- Sharp pain with sudden movements
- Gradual loss of ability to dress, wash hair or fasten clothing
Overview
Frozen shoulder, also called adhesive capsulitis, happens when the capsule — the sleeve of connective tissue that wraps around the shoulder joint — becomes inflamed, thickened and tight. The result is a shoulder that hurts and will not move properly, even when someone else tries to move it for you.
It usually develops without an obvious injury and tends to pass through three overlapping phases. In the "freezing" phase, pain builds and movement gradually shrinks. In the "frozen" phase, pain often settles a little but stiffness dominates: reaching behind your back, fastening a bra, or putting on a coat becomes very difficult. In the "thawing" phase, movement slowly returns.
The whole process is often long — commonly a year or more — and the timeline varies a lot between people. It is most common between the ages of 40 and 60, slightly more common in women, and much more common in people with diabetes or thyroid conditions.
Causes and risk factors
- Age 40–60
- Diabetes or thyroid disease
- A period of not moving the shoulder (after surgery, a fracture, or an arm in a sling)
- A previous shoulder injury or rotator cuff problem
- Possibly a family history of frozen shoulder
- Dupuytren's disease of the hand (a related connective tissue condition)
How we may be able to help
Our first step is a careful assessment to confirm the diagnosis — a frozen shoulder loses movement in a characteristic pattern, especially outward rotation, and this helps distinguish it from rotator cuff problems or arthritis. If the picture is unclear, we can arrange an online private GP consultation to request imaging.
Treatment is matched to the phase you are in. During the painful freezing phase, physiotherapy focuses on calming the shoulder: gentle mobilisation, interferential therapy for pain relief, and advice on positions and sleep. As pain settles and stiffness dominates, we progress to firmer joint mobilisation, soft tissue techniques such as IASTM and cupping for the tight muscles around the shoulder blade, and a graded stretching and strengthening programme that you continue between sessions.
Our chiropractor can also assess and treat the neck and upper back, which often become stiff and overworked when the shoulder is not moving well. Many people find this combined approach helps them keep function and reduce pain while the condition runs its course.
What you can do at home
- Keep using the arm within comfort for everyday tasks — complete rest tends to make stiffness worse
- Do short, frequent stretches (several times a day) rather than one long painful session
- Use a warm pack on the shoulder before stretching
- Sleep with a pillow supporting the arm so the shoulder is not pulled into a painful position
- Avoid sudden jerking movements, which can flare the pain for days
- If you have diabetes, keeping blood sugar well controlled may help your recovery
When to seek urgent help
If you have any of the following, call us straight away for an urgent same-day appointment — we can examine you and arrange fast-track X-ray or MRI through our imaging partner. If you cannot reach us, go to A&E. For loss of bladder or bowel control, numbness around the groin, chest pain, a sudden severe headache or rapidly worsening weakness, call 999 or go to A&E immediately:
- A hot, red, swollen shoulder with fever — possible joint infection
- Stiffness that began after a fall or a sudden pull, with a visibly deformed shoulder
- Unexplained weight loss, night sweats or a history of cancer alongside shoulder pain
- Shoulder pain with chest tightness, breathlessness or pain spreading down the left arm
Frequently asked questions
Do I need an X-ray or MRI?
Often not. Frozen shoulder is usually diagnosed by examination. An X-ray is sometimes useful to rule out arthritis, and we can arrange this through an online GP consultation if it would change the plan.
Should I push through the pain when stretching?
Stretch to the point of a firm pull, not sharp pain. Aggressive stretching in the painful phase can make things worse; gentle, frequent movement works better.
Will it come back?
The same shoulder rarely freezes twice, but a proportion of people later develop it on the other side, particularly those with diabetes.
Can I still go to the gym?
Yes — lower body, core and cardio work are fine. Avoid overhead pressing and heavy pulling until your therapist clears those movements.
This page is general information, not a diagnosis. A clinician will assess you before recommending any treatment. Outcomes vary from person to person. Written with reference to NHS and other peer-reviewed guidance.
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