Frozen shoulder makes the shoulder painful and stiff in almost every direction, often for many months. The pain and stiffness do usually ease with time, and physiotherapy matched to your stage keeps you comfortable and helps you get your movement back.
The medical name is adhesive capsulitis. At Tylurs com, our physiotherapists help you understand which stage you are in, keep your shoulder moving within comfortable limits and rebuild movement and strength as it recovers.
Key takeaways
- Frozen shoulder happens when the joint capsule becomes inflamed, then thickens and tightens.
- It moves through freezing, frozen and thawing stages and can take months or years to settle.
- Treatment is matched to your stage: gentle movement first, stronger stretching later.
- Shoulder pain with chest pain or breathlessness needs emergency help straight away.
Common symptoms of frozen shoulder
Frozen shoulder usually starts as a deep ache and gradually stiffens. Typical signs include:
- Deep ache in the shoulder and upper arm
- Pain that is often worse at night
- Stiffness in every direction, not just lifting
- Difficulty reaching behind your back
- Trouble with hair washing, dressing or seat belts
- Sharp pain with sudden or quick movements
What is frozen shoulder?
Your shoulder is a ball-and-socket joint wrapped in a flexible sleeve of tissue called the capsule. In frozen shoulder, the NHS explains, this capsule becomes inflamed, then thickens, tightens and shrinks. The joint has less room to move, so it becomes painful and stiff. It is often unclear why it starts, and it usually affects one shoulder at a time.
The three stages of frozen shoulder
The condition typically moves through three overlapping stages, and their length varies a great deal from person to person.
| Stage | What you tend to notice | What treatment focuses on |
|---|---|---|
| Freezing (painful) | Pain builds, often worse at night, and movement reduces | Calming pain, gentle movement, sleep advice |
| Frozen (stiff) | Pain eases somewhat, but stiffness dominates | Stretching within comfort, keeping everyday function |
| Thawing (recovery) | Movement gradually returns | Stronger stretching, strengthening, return to activity |
The NHS says frozen shoulder can take months or years to get better, and Arthritis UK notes it can take two to three years to settle fully. Physiotherapy cannot fast-forward the process, but it helps you stay as comfortable and capable as possible while it runs its course.
Who is more likely to get it?
- people aged roughly 40 to 60, more often women than men
- people with diabetes or thyroid problems
- anyone whose arm has been immobilised after a fracture, operation or injury
- people recovering from a heart attack or stroke
If you fall into one of these groups, keep the shoulder gently moving after any injury and seek early advice if stiffness starts to creep in.
Frozen shoulder or something else?
The most common alternative is a rotator cuff problem, a form of tendinopathy. With adhesive capsulitis, the joint is stiff in all directions and will not move further even when your physiotherapist moves it for you; with a rotator cuff problem, someone else can usually move your arm further than you can. Rotator cuff pain often catches in a particular arc, while frozen shoulder aches through most movements and at rest.
Pain from the neck can also be felt around the shoulder blade, so we always check your neck too. Pain centred on the outer elbow when gripping points more towards tennis elbow.
How physiotherapy helps frozen shoulder
According to the NHS, a course of physiotherapy usually lasts at least six weeks and can include stretching, strengthening and posture advice. At the Tylurs com physiotherapy clinic, we match treatment to your stage, so you are never pushed harder than your shoulder can tolerate.
Pain-guided movement
In the painful phase, aggressive stretching tends to backfire. Pendulum swings, table slides and supported arm raises keep the joint moving without provoking it. Keeping the shoulder completely still makes pain worse.
Stretching as the pain settles
Once night pain eases, stretches become more sustained: a stick to help the arm turn outwards, a towel stretch for reaching behind your back, wall walks and cross-body stretches. Short sessions spread through the day work better than one long, painful session. A wrapped heat pack beforehand often helps, and our guide to ice or heat for injury explains why heat usually suits stiff shoulders.
Hands-on care and strength
Our manual therapy eases pain around the shoulder blade and neck and makes movement more comfortable, always alongside exercise. As movement returns, we strengthen the rotator cuff and shoulder blade muscles so the shoulder feels reliable again for lifting, reaching overhead and work.
Sleep and everyday positions
Try lying on your back with a pillow under the affected arm. During the day, dress the painful arm first and undress it last, and keep frequently used items between waist and shoulder height.
Other treatments your doctor may discuss
Physiotherapy often works alongside medical treatment. Your GP or a specialist may suggest:
- Pain relief, with advice from your GP or pharmacist.
- Steroid injection, which can reduce pain in the early stage and make exercise easier; the effect is temporary.
- Hydrodilatation, an ultrasound-guided injection to stretch the tight capsule.
- Surgery for a small number of people with severe, persistent stiffness, always followed by rehabilitation.
When to seek urgent medical help
- Shoulder or arm pain with chest pain, breathlessness, sweating or nausea could be a heart attack. Call your local emergency number immediately.
- A deformed shoulder after a fall, or an arm you cannot move at all, may be a fracture or dislocation.
- A hot, red, swollen shoulder or a high temperature can signal infection and needs same-day advice.
- Suddenly being unable to lift your arm after an injury needs prompt assessment for a tendon tear.
Book frozen shoulder physiotherapy
You do not have to wait it out on your own. The Tylurs com team gives you a clear picture of your stage, practical ways to sleep and function better, and a programme that adapts as your shoulder changes. You can also explore other conditions we treat.
Book your shoulder assessment and start getting your movement back.
Frozen shoulder: frequently asked questions
Will a frozen shoulder get better on its own?
For most people, yes. The pain and stiffness usually ease eventually, even without treatment, but recovery can take months or even a few years. Treatment cannot switch the condition off, but it makes the painful phase more manageable, protects sleep and daily function, and helps you regain movement as the shoulder loosens.
Should I push through the pain when stretching a stiff shoulder?
No. Forcing a painful, inflamed shoulder usually makes it more irritable and can set you back. A mild stretch that fades within minutes of stopping is fine. Sharp pain, or an ache that lingers for hours or disturbs sleep, means you have done too much. Stretches get stronger as pain settles.
Is a steroid injection better than physiotherapy for frozen shoulder?
They do different jobs and often work well together. An injection can reduce pain, particularly in the early painful phase, but it does not restore movement by itself. Exercise and physiotherapy help you regain range and function, and many people find an injection makes their exercises easier to do.
What is the best sleeping position with a painful shoulder?
Most people find lying on their back with a pillow under the affected arm, supporting the elbow slightly forward, most comfortable. If you prefer your side, lie on the good side and hug a pillow so the sore arm rests on it. Avoid lying directly on the painful shoulder while it is irritable.
References
Sources reviewed by our physiotherapists for this guide:
- Frozen shoulder – NHS
- Shoulder pain: symptoms, causes and treatment – Arthritis UK
- Physiotherapy – NHS
