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
Frozen shoulder follows a predictable pattern of three overlapping phases:
Intervention during the freezing or frozen phase can significantly shorten the overall course and reduce the severity of symptoms.
Treatment is guided by the stage of the condition and how much it is affecting your daily life.
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.
You may have more options than you think
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.
Protect what you have. Slow degeneration and manage symptoms.
Fix specific damage. Torn tissue, unstable joints, structural problems.
Rebuild lost tissue. Biological treatments that stimulate new growth.
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.
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.
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.
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.
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.
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