Frozen shoulder can be a confusing and frustrating condition. It often starts with a vague ache, then over weeks to months the shoulder becomes painful and increasingly stiff, until simple tasks like reaching behind your back, doing up a bra or putting on a seatbelt become a real challenge.
Understanding the typical stages of frozen shoulder can make the journey feel a lot less uncertain. While it can take a long time to run its course, many people regain much of their movement, and there are practical steps that may help you manage pain and keep your shoulder working along the way.
What is frozen shoulder?
Frozen shoulder, also called adhesive capsulitis, is a condition where the capsule surrounding the shoulder joint becomes inflamed, then thickened and tight. As the capsule contracts, the space inside the joint shrinks and movement becomes restricted in every direction.
A key feature is that the shoulder is stiff whether you move it yourself or someone else moves it for you. This helps distinguish it from conditions such as rotator cuff problems, where strength or pain may limit movement but the joint itself is not locked down. Our page on rotator cuff and shoulder injuries explains some of those other causes.
Who gets frozen shoulder?
Frozen shoulder most commonly affects people between about 40 and 60, and it is more common in women. Often there is no obvious trigger, but certain factors increase the risk:
Diabetes, which is one of the strongest known risk factors
Thyroid conditions
A period of reduced shoulder movement, such as after surgery, a fracture or a sling
Some other health conditions, including heart disease and Parkinson's disease
Having had frozen shoulder on the other side
If you have diabetes and develop new shoulder pain and stiffness, it is worth mentioning to your GP, who can also help with managing your blood sugar levels.
What are the stages of frozen shoulder?
Frozen shoulder is usually described in three overlapping stages. Not everyone follows the pattern neatly, and the timeframes below are only a rough guide.
Stage 1: Freezing (painful phase). Pain gradually builds and is often worse at night, making it hard to lie on that side. Movement starts to become restricted. This phase commonly lasts from around two to nine months.
Stage 2: Frozen (stiff phase). Pain often begins to ease, but stiffness becomes the main problem. Reaching overhead, out to the side or behind your back can be significantly limited. This phase may last from around four to twelve months.
Stage 3: Thawing (recovery phase). Movement slowly returns. This can be a gradual process taking anywhere from several months to two years. Many people regain most of their range, although some are left with a degree of ongoing stiffness.
How long does frozen shoulder last?
Overall, frozen shoulder commonly lasts from one to three years from start to finish. That can sound daunting, but symptoms usually change over that time, and the most painful period is often in the first several months.
Research suggests that a proportion of people have some lasting stiffness or discomfort beyond this, particularly those with diabetes. Treatment cannot always shorten the natural course, but it may help you manage pain, sleep better and keep doing daily tasks while the shoulder recovers.
How is frozen shoulder treated?
Treatment depends on which stage you are in and how much pain you have. A thorough assessment helps match the approach to your shoulder rather than following a one size fits all plan. Options may include:
Pain management: advice on positions for sleeping and working, heat, and discussion with your GP or pharmacist about suitable pain relief
Gentle movement: in the painful phase, exercises within comfortable limits rather than forcing through pain
Progressive mobility and strength work: as pain eases, exercises to gradually restore range and keep the surrounding muscles strong
Hands-on care: joint mobilisation and soft tissue work may help some people with pain and movement
Medical options: your GP may discuss a corticosteroid injection, which research suggests may help pain in the early stages, or hydrodilatation, where fluid is injected to stretch the capsule
Surgical options: for persistent cases, an orthopaedic surgeon may discuss procedures such as capsular release
A physiotherapist or osteopath can guide your exercise program and adjust it as the shoulder moves through each stage. You can read more on our frozen shoulder treatment page.
How can you manage everyday tasks with a frozen shoulder?
Small changes to daily routines can make a stiff, painful shoulder easier to live with while it recovers. Many people find these ideas helpful:
- Put the sore arm into sleeves first when dressing, and take it out last when undressing.
- Move frequently used items in the kitchen and bathroom to between waist and shoulder height to limit overhead reaching.
- Try hugging a pillow or resting the arm on a pillow when lying down, which some people find more comfortable at night.
- Break up long periods at a desk or on a device, as staying in one position can add to neck and shoulder tension.
- Check with your GP or practitioner before driving if turning the wheel or checking blind spots is difficult.
As range improves, a structured program such as mobility, strength and movement therapy may help you rebuild confidence in using the arm.
When should you see a GP or seek urgent care?
Not all shoulder pain is frozen shoulder. Some symptoms need prompt medical attention:
Shoulder or arm pain with chest pain, shortness of breath, sweating or nausea: call 000
Pain and loss of movement after a fall or injury, especially with visible deformity
A hot, red, swollen shoulder, or fever and feeling unwell
Sudden weakness, or numbness and tingling down the arm
Unexplained weight loss, or constant pain that does not change with position
Frequently asked questions
Should I push through the pain to keep my shoulder moving?
Generally not during the painful freezing phase. Forcing movement can aggravate pain without speeding recovery. Gentle exercise within comfortable limits is usually recommended early on, with more progressive stretching introduced as pain settles.
Can frozen shoulder come back?
It is uncommon for frozen shoulder to return in the same shoulder, but some people develop it in the other shoulder later on. This is more common in people with diabetes.
Can I use a Medicare care plan for frozen shoulder?
If you have a chronic condition, your GP may be able to set up a Chronic Condition Management plan, which provides a Medicare rebate for a limited number of allied health visits per calendar year. Talk to your GP about whether you are eligible.
Getting help on the Gold Coast
If your shoulder is painful, stiff or keeping you up at night, our team at The Good Joint in Mermaid Beach can assess what is going on and help you manage each stage. Find out more about our shoulder pain care or book online today.
Related reading: Why does my shoulder hurt when I lift my arm? and How many physio sessions will I need?
