What is a frozen shoulder?
A frozen shoulder happens when the capsule and tissue around the joint becomes inflamed. The inflammation can make your shoulder stiff and painful. Frozen shoulder is also called adhesive capsulitis, because the tissue around your shoulder joint sticks together through adhesions.
What are the symptoms of frozen shoulder?
The symptoms of frozen shoulder include:
Pain, which gets worse at night
Reduced range of shoulder movement
The symptoms can vary over the different stages of frozen shoulder.
What are the stages of frozen shoulder?
There are 4 stages of frozen shoulder.
As the inflammation begins in the shoulder you may start to notice pains when you move your shoulder joint, especially reaching behind your back or above your head.
Freezing: 3-9 months
The shoulder progressively gets worse. It can be harder to sleep and you may lose range of movement because of the pain and stiffness. At the end of this stage your shoulder pain will be at its strongest.
Frozen: 9-14 months
Pain should start to settle down, leaving you with a small range of movement in the shoulder. The joint will stiffen and using your arm can be difficult. Pain will often only start when you try to move your arm past its small comfortable range of movement.
Thawing: 12-15 months
As your shoulder starts to loosen it should be more comfortable to move your arm. This is a slow process and it can ache much like when the pain started, including being uncomfortable at night.
How common is frozen shoulder?
Around 1 in 10 women and 1 in 13 men will suffer from a frozen shoulder in their lifetime. It’s most common between 40-60 years of age. According to a survey, 14% of people who have a frozen shoulder will get it in both shoulders.
What causes frozen shoulder?
There are several causes and risk factors for frozen shoulder:
If your shoulder is held still for a long period of time after a medical procedure e.g. a mastectomy or a stroke
An injury to the shoulder or rotator cuff muscles
How long does frozen shoulder last?
A frozen shoulder can last from months to years. It can take 1-3 years to recover from a frozen shoulder.
How is frozen shoulder diagnosed?
A doctor will ask you about the pain and how it’s affecting you. When you see your doctor they will ask you to show them how far you can move your arm. They may take the weight of your arm and try moving it while you’re relaxed. This won’t be possible with a frozen shoulder.
Frozen shoulder test:
Bend your elbows to 90° and keep them in by your sides. Without moving your upper arm away from your body, move your hands outwards (lateral rotation). You should be able to extend your good arm further out than your affected arm.
If a GP decides a second opinion is needed you may be referred to a shoulder specialist in orthopaedics. They may perform tests, such as blood tests, and imaging like an X-ray or MRI.
How is frozen shoulder treated?
A GP may be able to help your frozen shoulder by:
Pain management: They may recommend taking medication, using heat packs or a TENS machine.
Physiotherapy referral: It’s really important to start frozen shoulder exercises early and keep doing it to stretch the muscles and keep your stiffening shoulder mobile.
Steroid Injections: Steroids can be injected into the fluid inside the joint to bring down inflammation that's causing you pain. This may be done by a trained GP or a specialist.
Very rarely surgery may be an option, but this should be discussed with a shoulder specialist.
When should I talk to a doctor about a frozen shoulder?
Seek advice from a doctor if you believe you have a frozen shoulder. If you have a new, unexplained loss of movement in your arm, this should be examined.
Seek urgent advice if there are skin changes overlying your shoulder that could suggest infection of the skin or joint. This would look like a red, swollen shoulder that is hot to the touch and painful.
- Reviewed by:
- Dr Bryony Henderson