Frozen Shoulder
Frozen shoulder, also called adhesive capsulitis, causes pain and progressive stiffness in the shoulder. Reaching overhead, putting on clothes, fastening a bra or sleeping on the affected side can gradually become difficult. A proper assessment helps confirm whether the problem is frozen shoulder or another cause of shoulder pain.
What frozen shoulder is
The shoulder is surrounded by a flexible tissue called the joint capsule. In frozen shoulder, this capsule becomes inflamed, thickened and tight, which reduces the space available for movement. Symptoms often develop gradually rather than appearing all at once, and typically move through three broad stages. In the freezing stage, pain builds up and movement begins to reduce, with night pain that can be particularly troublesome. In the frozen stage, pain may ease but stiffness remains and dressing, reaching and daily activities can still be difficult. In the thawing stage, movement gradually returns, though recovery is often slow and varies from person to person. The stages are not always clearly separated, and every patient's experience is different.
Symptoms to look out for
Deep or aching shoulder pain that is often worse at night
Gradually increasing stiffness in the shoulder
Reduced range of movement when you move the arm yourself and when someone moves it for you
Difficulty reaching a high shelf, combing or washing your hair, or putting on a shirt
Trouble reaching behind your back, driving comfortably or sleeping on the affected side
Symptoms that develop gradually rather than after a single injury
Why this matters to a rheumatologist
Frozen shoulder can occur without an obvious reason, but several factors are associated with a higher risk, including age around 40 to 60, diabetes, thyroid conditions, a previous shoulder injury or surgery, and periods when the arm had to be kept still. It is not simply caused by using the shoulder too much or by poor posture. Shoulder pain and stiffness can also come from rotator cuff problems, arthritis, referred neck pain or inflammatory joint disease, so my job is to work out which pattern fits you. This matters because inflammatory arthritis and some autoimmune conditions can affect the shoulder too, and identifying them early guides very different treatment.
Signs I would like you to seek care for
For emergency symptoms please seek urgent or emergency care first rather than waiting for a WhatsApp reply.
A significant shoulder injury or visible deformity, or sudden inability to move the arm
A red, hot or markedly swollen shoulder with fever
Chest pain, breathlessness, sweating or pain spreading to the jaw
New or worsening weakness, numbness or loss of sensation in the arm
Shoulder pain and stiffness that are not improving, disturbing your sleep, or making dressing, bathing or driving difficult
Both shoulders affected, or pain and swelling in other joints too
What a specialist review looks like
In clinic I start with a careful discussion of your symptoms and medical history, then examine how far the shoulder moves when you move it yourself and when I move it for you. I look at the neck, the surrounding tendons and the other joints, and consider conditions that can mimic frozen shoulder. Imaging such as X-ray, ultrasound or MRI is not always needed to diagnose frozen shoulder, but may be arranged when I want to exclude another cause. Treatment is tailored to the stage and severity, and usually focuses on controlling pain, keeping safe movement going, and gradually restoring function. This may include education and activity adjustment, suitable pain relief, gentle stage-appropriate movement, a physiotherapy programme, and in selected patients a corticosteroid injection to reduce pain and inflammation. Most people are managed without surgery, and further specialist procedures are only considered when symptoms remain severe despite appropriate conservative care.
Questions my patients often ask me
Speak with me
Shoulder pain and stiffness can have more than one cause. An assessment can help determine whether your symptoms are due to frozen shoulder or another shoulder, joint or inflammatory condition, so we can plan the right next step together.
Other conditions I treat
This page is for general education only and does not replace medical advice. Please consult a qualified healthcare professional for diagnosis and treatment.