- Stiff shoulder that just won’t move?
- No recent shoulder injury or surgery?
You may have a frozen shoulder.
Frozen shoulder (Adhesive Capsulitis) happens when the connective tissue surrounding your shoulder joint thickens and becomes tight and inflamed. Stiff tissues known as adhesions build up in the shoulder capsule. The capsule is the lining of the shoulder joint which is normally quite loose and elastic to allow movement in all directions. The build-up of adhesions restricts and ‘blocks’ movement so you cannot move your shoulder and causes pain.
The three key symptoms of frozen shoulder
Unlike other shoulder injuries such as a rotator cuff tear or conditions such as arthritis, frozen shoulder has three distinct symptoms:
1. Persistent Pain
Frozen shoulder causes a deep, aching pain in your shoulder joint and upper arm. A quick movement to reach for something, such as putting on a seatbelt, can cause a short, stabbing pain too. The pain is much worse at night and it’s almost impossible to sleep resting on the affected shoulder.
2. Stiffness / Blocking
A frozen shoulder feels “blocked” so that you cannot physically move it yourself. It gets progressively worse too, often preventing you putting your hands behind your back to tuck in your shirt, shirt or do up a bra strap, for example. You may not be able to lift your arm above your head, or even just enough to brush your hair.
3. Passive vs. Active Movement
With many shoulder injuries, the joint can be moved, or your arm raised by someone else, even if you can’t do it yourself. With a frozen shoulder, if a doctor or another person moves your arm, the shoulder won’t physically move at all.
Getting a diagnosis for frozen shoulder
When you book a consultation with our shoulder and elbow specialist consultants at Joint Reaction, they will examine you and assess your range of movement and pain. They may then send you for imaging tests such as an x-ray, MRI, or ultrasound to rule out other conditions such as a rotator cuff injury (2).
It’s important to see your consultant before you get the imaging done, or if you have pre-existing scans. Our orthopaedic surgeons will ensure that the imaging is taken from exactly the right place and in the right plane (angle). (For more details see our previous article).
To book a rapid appointment with one of our specialist shoulder and elbow orthopaedic consultants in a matter of days, not weeks:
- Call us on 01252 851285
- Email us
- View our consultants
The 3 stages of frozen shoulder
Frozen shoulder can come on gradually or quite rapidly and goes through three phases.
1. Freezing
Your shoulder is increasingly painful, especially at night. Your start to lose the range of motion in your shoulder
2. Frozen
The pain may ease, but your shoulder is at its stiffest. Everyday tasks like reaching for a seatbelt or brushing your hair become remarkably difficult.
3. Thawing
Your shoulder gradually begins to loosen and your normal range of movement slowly returns almost to normal.
Frozen shoulder therapies
The aim of your treatment for a frozen shoulder is to first reduce the pain and then restore the movement. Treatment may therefore include standard pain killers (analgesics) and anti-inflammatory medication such as ibuprofen and paracetamol.
An injection of steroid and local anaesthetic into the joint itself. By reducing the pain, you can move your shoulder more and hopefully prevent significant stiffness. Your consultant may also prescribe physiotherapy and exercises to do at home.
Only 30% of patients who come to Joint Reaction actually require surgery. 70% of patients receive shoulder freeze treatments tailored to their precise needs and make a good recovery. If symptoms persist and the shoulder does not thaw, your consultant may suggest surgery, followed by physio and other mobilisation methods to keep the shoulder moving and preventing stiffness due to inactivity.
Frozen shoulder FAQs
The precise cause of frozen shoulder is unclear, but it is not directly related to trauma (injury) . More research is definitely needed!
Statistically, those with diabetes do appear to be more at risk, as do those with hypothyroidism (4). A stroke or a mastectomy may result in your arm being far less mobile, which can present a risk of developing frozen shoulder. There is also a possible raised risk factor during the menopause due to changes in oestrogen levels, but this has not been fully supported by research yet. (5)
Quite why frozen shoulder happens is unclear, but it does not seem to develop due to injury. Having said that, the shoulder may freeze if it is inactive for a prolonged period due to recovery from a previous injury.
Actually, it’s the other way around. Frozen shoulder can affect up to 10% of women and 8.3% of men in the most at risk age group of 35-55 year olds.(1)
Always take advice from your consultant or physiotherapist as to which specific exercises you should do.(3) In general, home exercises for frozen shoulder involve short 10 minute sessions performed 3-4 times a day using home furniture such as chairs, tables and walls. These include:
• Pendulum Swings
• Wall Slides
• Towel Stretches
• The Stick Exercise (Assisted External Rotation)
• Cross-body reaches
Your consultant or physio may suggest heating your muscles with a heat pack before exercising too.
The main differences between a between a rotator cuff injury and a frozen shoulder are in the table below. For an expert diagnosis, contact us to book your private consultation and start your treatment earlier. 
Sore shoulder and no GP appointment?
Contact us to book a private consultation with one of our specialist orthopaedic surgeons. You don’t need a referral and there’s no obligation to continue with private treatment afterwards. However, ‘going private’ will involve more rapid diagnosis, treatment and surgery (if required), so you won’t be in pain for so long or risk further stiffness.
Don’t have private medical insurance? Remember that if your partner/spouse has private medical insurance through work, it might cover you too!
For more details, or to book an appointment with an orthopaedic surgeon near you, contact us at Joint Reaction.
IMPORTANT: This article on frozen shoulder is for your information only. It is not intended as a substitute for professional medical advice or diagnosis. When you first meet your Joint Reaction consultant, they will talk through your symptoms and discuss any previous diagnosis or scans you may have.
SOURCES:
(1) Brealey S, Armstrong AL, Brooksbank A, et al. United Kingdom Frozen Shoulder Trial (UK FROST), multi-centre, randomised, 12 month, parallel group, superiority study to compare the clinical and cost-effectiveness of Early Structured Physiotherapy versus manipulation under anaesthesia versus arthroscopic capsular release for patients referred to secondary care with a primary frozen shoulder: study protocol for a randomised controlled trial. Trials. 2017;18(1):614. Published 2017 Dec 22. doi:10.1186/s13063-017-2352-2
(2) British Elbow & Shoulder Society. (n.d.). Subacromial shoulder pain. https://bess.ac.uk/subacromial-pain/
(3) Harvard Health Publishing. (2023, June 26). How to release a frozen shoulder: 5 stretches to use. https://www.health.harvard.edu/pain/how-to-release-a-frozen-shoulder-5-stretches-to-use
(4) Deng G, Wei Y. The causal relationship between hypothyroidism and frozen shoulder: A two-sample Mendelian randomization. Medicine (Baltimore). 2023;102(43):e35650. doi:10.1097/MD.0000000000035650
(5) Navarro-Ledesma S. Frozen Shoulder as a Systemic Immunometabolic Disorder: The Roles of Estrogen, Thyroid Dysfunction, Endothelial Health, Lifestyle, and Clinical Implications. J Clin Med. 2025;14(20):7315. Published 2025 Oct 16. doi:10.3390/jcm14207315