Frozen Shoulder: What It Is and How Long It Lasts

Frozen shoulder - adhesive capsulitis - is one of the more frustrating conditions we treat. Not because it's dangerous, but because it takes a long time, causes significant pain and limitation, and often comes on for no obvious reason. Understanding the stages helps manage expectations and keeps people engaged with treatment.

Stage 1: The freezing phase (2-9 months)

Pain is the dominant feature. It develops gradually, often waking people at night, and is characterised by an aching quality that is hard to position away from. Movement starts to become restricted but pain is the bigger problem. This is the most frustrating phase because it can feel like nothing is working.

Stage 2: The frozen phase (4-12 months)

Pain typically reduces but movement restriction is at its worst. The shoulder is stiff in all planes - especially external rotation and abduction. Daily activities like reaching into the back seat of a car, doing up a bra, or combing hair become difficult. Function is significantly impacted but the pain is more manageable.

Stage 3: The thawing phase (5-24 months)

Range of motion gradually returns. This phase can be slow and non-linear - there are periods of improvement followed by plateaus. Most people recover full or near-full movement, though a small percentage retain some permanent restriction.

What helps

During the freezing phase: pain management is the priority - anti-inflammatories, heat, and gentle movement within comfort. A corticosteroid injection into the glenohumeral joint in this stage can significantly reduce the severity and duration of the freezing phase and is often worth discussing with your GP or specialist.

During the frozen and thawing phases: progressive stretching and range-of-motion work. Hydrodilatation (an injection that stretches the capsule) is a more aggressive option that can speed recovery in the frozen phase. Physiotherapy remains valuable throughout to guide the progression of movement work and prevent compensation from developing.