Frozen Shoulder

Name: Frozen Shoulder (Adhesive Capsulitis)
Creator: Prof Paul Lee

Frozen shoulder (adhesive capsulitis) causes progressive stiffness and pain as the joint capsule tightens around the shoulder. It restricts movement in all directions and can significantly impact daily life and sleep.

Reviewed byProf Paul Lee MBBch, FRCS (Tr & Orth), PhDLast reviewed 1 May 2026

Specialist explaining frozen shoulder stages

The three stages of frozen shoulder

Frozen shoulder follows a predictable pattern of three overlapping phases:

Freezing (2 to 9 months): gradual onset of pain, often severe. Movement progressively restricted.
Frozen (4 to 12 months): pain may ease but stiffness is at its worst. Reaching, dressing, and sleeping are significantly affected.
Thawing (5 to 24 months): gradual return of movement. The rate of recovery varies considerably between patients.

Intervention during the freezing or frozen phase can significantly shorten the overall course and reduce the severity of symptoms.

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Treatment options

Treatment is guided by the stage of the condition and how much it is affecting your daily life.

Corticosteroid injection to reduce capsular inflammation, particularly effective in the freezing phase.
Hydrodilatation: injection of saline and steroid under pressure to stretch and expand the tight capsule.
Structured physiotherapy to maintain and restore movement as the capsule responds.
Arthroscopic capsular release for cases that do not respond to conservative measures.

At London Cartilage Clinic, we assess which phase you are in and match the treatment intensity to the stage. Not every frozen shoulder needs the same approach.

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Shoulder physiotherapy and rehabilitation

You may have more options than you think

Most patients have more treatment options than they have been told

At London Cartilage Clinic we follow a structured clinical framework across four areas of treatment. Before recommending a single procedure, we assess which combination of approaches gives you the best outcome.

Preserve

Protect what you have. Slow degeneration and manage symptoms.

Repair

Fix specific damage. Torn tissue, unstable joints, structural problems.

Regenerate

Rebuild lost tissue. Biological treatments that stimulate new growth.

Replace

When other options are exhausted. Joint replacement as a last resort.

Explore the full range of treatments available for your joint. Each hub page shows every option we offer, organised by clinical approach.

Explore Shoulder Options

Frequently Asked Questions

What causes frozen shoulder?

The exact cause is not fully understood. The joint capsule becomes thickened and inflamed, forming adhesions that restrict movement. Risk factors include diabetes, thyroid conditions, previous shoulder injury or surgery, and prolonged immobility. It is more common in women aged 40 to 60.

How long does frozen shoulder last?

Without treatment, frozen shoulder typically follows a course of one to three years through three phases: freezing (increasing pain and stiffness), frozen (persistent stiffness with easing pain), and thawing (gradual return of movement). Treatment can shorten this timeline significantly.

What treatments can speed up recovery?

Options include corticosteroid injections to reduce capsular inflammation, hydrodilatation (injecting fluid to stretch the capsule), physiotherapy to maintain and restore movement, and in resistant cases, arthroscopic capsular release to surgically divide the tight capsule.

Is frozen shoulder the same as a rotator cuff tear?

No. Frozen shoulder is a capsular condition causing global restriction of movement. A rotator cuff tear involves tendon damage causing weakness. However, the two can coexist and sometimes a rotator cuff problem triggers the capsular response. Accurate diagnosis distinguishes between them.

Still have more specific concerns?

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London Cartilage Clinic

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