Frozen shoulder: the stages, what helps and how long it takes

A frozen shoulder becomes painful and then increasingly stiff, until everyday tasks like reaching up to a shelf, putting on a shirt or fastening a bra become difficult. It can be slow and frustrating, but it does improve. Knowing what to expect at each stage helps.

What it is

In a frozen shoulder, the capsule around the shoulder joint becomes inflamed and then thickened and tight, which limits movement in every direction. It is more common between about 40 and 60, in women, and in people with diabetes or some thyroid conditions. It sometimes follows a period of not moving the arm, such as after an injury or surgery, but often appears without a clear cause.

The stages

Frozen shoulder usually goes through three overlapping stages:

1. Painful ("freezing"). Pain builds, often worse at night and when lying on that side. Movement starts to reduce.

2. Stiff ("frozen"). Pain often eases, but the shoulder is very stiff.

3. Recovery ("thawing"). Movement gradually returns.

The whole process often takes many months, and sometimes longer. Everyone's timeline is different.

How physiotherapy helps

Treatment depends on the stage.

In the painful stage, the aim is to ease pain and keep what movement you have, without aggravating it:

• gentle, pain-free movements

• advice on positions for sleeping and daily tasks

• pain relief as advised by your doctor

In the stiff and recovery stages, the aim is to regain movement and strength:

• stretching exercises, progressed gradually

• hands-on mobilisation of the joint

• strengthening as movement returns

• a home programme done every day

Your physiotherapist will also check that something else, such as a rotator cuff problem or pain from the neck, is not the cause.

Gentle exercises to try

Do these gently, within comfort. In the painful stage, less is more.

• Pendulum swings: lean forward supporting yourself with your good arm on a table, let the affected arm hang down, and gently swing it in small circles. 30 seconds, a few times a day.

• Table slides: sitting at a table, rest your hand on a towel and slide it forward, letting your body lean forward, then back. 10 times.

• Assisted lift: lying on your back, hold the wrist of the affected arm with your good hand and gently lift it overhead as far as is comfortable. 10 times.

A physiotherapist can show you which exercises suit your stage, and when to progress.

Living with it

• sleep with a pillow under the affected arm, or on your other side

• keep things you use often within easy reach

• use the arm for light everyday tasks as comfort allows

• if you have diabetes, keep it well controlled

See a doctor if

• the pain is severe and not controlled with simple pain relief

• the shoulder became painful after a fall or injury, or you cannot lift your arm at all

• there is swelling, redness, fever, or you feel unwell

• you have chest pain or breathlessness with shoulder pain (seek urgent help)

Doctors sometimes offer other treatments, such as injections, alongside physiotherapy.

Find a physiotherapist near you

Search for physiotherapists who treat shoulder problems on PhysioDesk Reach and contact them directly.

This article is general information, not medical advice.