Adhesive capsulitis (Frozen shoulder)
Adhesive capsulitis, commonly known as a frozen shoulder, is a condition that causes progressive pain, severe stiffness, and restricted movement in the shoulder joint.
Adhesive capsulitis overview
The shoulder is a ball-and-socket joint where the top of the upper arm bone (humerus) fits into the shoulder socket. The joint is surrounded by a strong, flexible capsule of connective tissue that holds the joint together, lubricated by synovial fluid so the arm can rotate smoothly. In a frozen shoulder, this capsule becomes inflamed, thickened, and tight, with less synovial fluid available to lubricate movement. As stiff bands of tissue (adhesions) develop, moving the shoulder becomes increasingly difficult and painful. The condition affects approximately 2% of the population, most commonly individuals between the ages of 40 and 60. While the exact trigger is not always clear, frozen shoulder is significantly more common in people with diabetes (affecting 10–20% of diabetic individuals), thyroid conditions (hyperthyroidism and hypothyroidism), Parkinson’s disease, or cardiac disease. It can also develop after a period of shoulder immobilisation following a fracture, injury, or surgery.
What are the stages and symptoms?
Frozen shoulder typically develops gradually across three distinct clinical stages
- The 'Freezing' Stage (6 weeks to 9 months): Pain gradually increases, often worse at night when sleeping on the affected side. As pain builds, the shoulder progressively loses its range of movement.
- The 'Frozen' Stage (4 to 12 months): Severe pain may begin to ease or dull, but joint stiffness becomes profound. Everyday tasks, such as dressing, reaching overhead, or putting on a seatbelt—become extremely difficult.
- The 'Thawing' Stage (6 months to 2 years): Shoulder mobility slowly begins to return, with pain continuing to subside until normal or near-normal function is restored.
How is a frozen shoulder diagnosed?
Diagnosing a frozen shoulder involves a thorough clinical evaluation by your consultant, who will assess both active movement (moving the arm yourself) and passive movement (when the consultant moves your arm for you). A hallmark of frozen shoulder is a clear restriction in both active and passive motion, particularly external rotation (turning the arm outwards).
An X-ray is routinely performed to rule out other potential causes of pain and stiffness, such as osteoarthritis or calcific tendonitis. In complex cases, an MRI scan may be arranged to assess the soft tissues, rotator cuff tendons, and joint capsule detail.
How is it treated?
Treatment focuses on controlling pain and restoring joint mobility, tailored to the specific stage of the condition.
Treatment routes for Adhesive capsulitis (Frozen shoulder)
In the early freezing and frozen stages, treatment focuses on symptom relief. Options include non-steroidal anti-inflammatory drugs (NSAIDs) and targeted corticosteroid injections into the joint capsule to calm inflammation. As acute pain settles, a structured physical therapy and gentle stretching program is introduced to preserve and restore mobility.
Recovery from a frozen shoulder
Immediate movement and pain control
Following keyhole surgery, early movement is key to prevent new scar tissue from forming. Focus on gentle range-of-motion exercises as directed by your physiotherapist. Dressings should be kept clean and dry, with stitches usually checked or removed around 10 to 14 days.
Restoring range of motion
Rehabilitation shifts toward progressive stretching exercises to regain overhead reach and rotation. You will gradually increase daily use of the arm for light household activities.
Strengthening and full recovery
As full mobility returns, targeted strengthening exercises for the rotator cuff and shoulder girdle muscles are introduced. Most patients regain functional movement within 6 to 12 weeks post-surgery.
Working with professionals and teams
Our shoulder specialists support professional athletes, sports teams, active individuals and people whose work places high demands on their shoulders. Working closely with radiologists, physiotherapists and the wider multidisciplinary team, they provide coordinated care from diagnosis through to rehabilitation, helping each person return safely to sport, work or everyday activities.
The same specialist expertise and collaborative approach are available to every patient, whatever your activity level or recovery goals.
Our Experts - Leaders in Shoulder Treatment
How to pay
We offer flexible options depending on how you choose to access care at Fortius. Whichever option you choose, we’ll help make the process clear and straightforward from the start.
Private medical insurance
If your care is covered by private medical insurance, we’ll usually invoice your insurer directly. Please check your policy in advance and request an authorisation code if your insurer requires one. You’ll be responsible for paying any policy excess or costs that aren’t covered by your insurance.
Paying for yourself
You don’t need private medical insurance to access care at Fortius. If you’re paying for your own treatment, our team will explain the costs clearly and provide a personalised quote before you decide whether to go ahead.