Common symptoms
- 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
Frozen shoulder is one of the most frustrating shoulder problems we see. It usually starts as a deep ache that disturbs your sleep, then stiffens until simple tasks such as washing your hair, fastening clothes or reaching for a seat belt become surprisingly hard. The pain and stiffness do usually ease with time, and the right support can make those months far more manageable.
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.
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, this capsule becomes inflamed, then thickens, tightens and shrinks, as the NHS explains. The joint has less room to move, so the shoulder becomes painful and stiff in almost every direction.
It is often not clear why it starts. Some people remember a minor strain or a spell of not using the arm, while many cannot link it to anything at all. It usually affects one shoulder at a time.
The three stages of frozen shoulder
The condition typically moves through three overlapping stages. Not everyone follows them neatly, and the length of each 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 starts to reduce | Calming pain, gentle movement, sleep and posture advice |
| Frozen (stiff) | Pain eases somewhat, but stiffness dominates | Stretching within comfort, keeping everyday function |
| Thawing (recovery) | Movement gradually returns | Stronger stretching, strengthening and return to full activity |
How long does it last?
Recovery is slow. The NHS says frozen shoulder can take months or years to get better, although the pain and stiffness usually go away eventually. Arthritis UK notes it can take as long as two to three years to settle fully. Some people are left with a little lasting stiffness at the very end of their range. 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?
Anyone can develop the condition, but it is more common in certain groups:
- People aged roughly 40 to 60, and it is seen more often in women than men.
- People with diabetes. The NHS notes that it is not clear why, but regular diabetes check-ups are important.
- People with thyroid problems, whether an underactive or overactive thyroid.
- After a period of immobilisation, for example after a fracture, an operation or an injury that stopped you using your arm normally.
- After a heart attack or stroke, when arm movement may be reduced for some time.
If you fall into one of these groups, keeping the shoulder moving gently after any injury or operation is sensible, and early advice is worth seeking if stiffness starts to creep in.
Frozen shoulder or a rotator cuff problem?
Shoulder pain has many causes, and the most common alternative is a rotator cuff problem. The rotator cuff is a group of four muscles and their tendons that hold the ball of the joint in its socket and help lift and turn the arm. Irritated or overloaded rotator cuff tendons are a form of tendinopathy.
The key differences are:
- Stiffness pattern. With adhesive capsulitis, the joint is stiff in all directions, especially turning the arm outwards, and it 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 yourself.
- Pain pattern. Rotator cuff pain often catches in a particular arc as you lift the arm out to the side, while frozen shoulder aches through most movements and at rest.
- Strength. Rotator cuff problems can make the arm feel weak, whereas a tight capsule mainly limits movement rather than strength.
Pain from the neck can also be felt around the shoulder blade and top of the shoulder, so we always check your neck too. Pain from a tight capsule often spreads into the upper arm, but pain centred on the outer elbow when gripping points more towards tennis elbow. An X-ray is sometimes arranged to rule out arthritis of the shoulder joint, which can cause similar stiffness.
How physiotherapy helps frozen shoulder
According to the NHS, a course of physiotherapy for frozen shoulder usually lasts at least six weeks and can include stretching, strengthening and posture advice. At Tylurs com, we match your 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. Instead, we use gentle movements such as pendulum swings, table slides and supported arm raises to keep the joint moving without provoking it. The NHS advises moving your shoulder, because keeping it still makes the pain worse, while avoiding movements that cause significant pain.
Stretching as the pain settles
Once night pain eases and stiffness takes over, stretches become more sustained and more frequent. Common examples include using 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 usually work better than one long, painful session.
Manual therapy
Hands-on techniques, such as gentle joint mobilisations and soft tissue work around the shoulder blade and neck, can ease pain and make movement more comfortable. Our manual therapy is always combined with exercise, because lasting gains in movement come from what you do between appointments.
Your home exercise programme
Most of your progress happens at home. You will get a short, clear routine, usually a few minutes several times a day, with guidance on how much discomfort is acceptable. The NHS advises against making up your own strenuous exercises, as gym equipment can make the pain worse. It also suggests a heat pack or hot water bottle wrapped in a tea towel for up to 20 minutes at a time, which many people find useful just before their exercises; our guide to ice or heat for injury explains why heat usually suits stiff shoulders better than ice.
Physio tip: Link your exercises to things you already do, such as boiling the kettle or brushing your teeth. Little and often is the habit that makes the biggest difference with a stiff shoulder.
Sleep and everyday positions
Poor sleep makes pain harder to cope with, so we spend time on this early. Try lying on your back with a pillow under the affected arm, or on your good side hugging a pillow. During the day, dress the painful arm first and undress it last, keep frequently used items between waist and shoulder height, and use the arm for light tasks rather than holding it tucked against your body.
Strength and return to activity
As movement returns, we strengthen the rotator cuff and shoulder blade muscles so the shoulder feels reliable again for lifting, reaching overhead, sport and work.
Other treatments your doctor may discuss
Physiotherapy often works alongside medical treatment. Depending on how painful and stiff your shoulder is, your GP or a specialist may suggest:
- Pain relief. Your GP or pharmacist can advise on suitable painkillers; stronger medicines are usually used only for a short time because of side effects.
- Steroid injection. This can reduce pain, particularly in the early painful stage, and may make exercise easier. The effect is temporary.
- Hydrodilatation. Also called hydrodistension, this involves injecting a steroid, local anaesthetic and a salt-water solution into the joint, guided by ultrasound, to stretch the tight capsule.
- Surgery. For a small number of people with severe, persistent stiffness, a surgeon may release the tight capsule through keyhole surgery or move the joint under anaesthetic. Physiotherapy afterwards is essential, and our post-surgery rehabilitation service supports you through it.
When to seek urgent medical help
Shoulder pain is sometimes a sign of something more serious. Get help straight away if:
- You have shoulder or arm pain with chest pain, tightness, breathlessness, sweating or nausea. This could be a heart attack. Call your local emergency number immediately.
- Your shoulder looks deformed after a fall or injury, you cannot move your arm at all, or your arm or hand is numb. Get emergency care, as this may be a fracture or a dislocated shoulder.
- Your shoulder is hot, red or swollen, or you have a high temperature or feel generally unwell. This can be a sign of infection and needs same-day medical advice.
- You suddenly cannot lift your arm after an injury. A torn rotator cuff tendon needs prompt medical assessment.
See your GP if you have unexplained weight loss, night pain that does not ease with any position, or a history of cancer alongside new shoulder pain.
Book frozen shoulder physiotherapy at Tylurs com
You do not have to wait it out on your own. At Tylurs com, we give you a clear picture of where you are in the recovery process, practical ways to sleep and function better, and a progressive programme that adapts as your shoulder changes. If you would like to know how we work before you commit, our guide to your first physiotherapy appointment sets out what happens.
Book your shoulder assessment and start getting your movement back.
This page is for general information and does not replace a personal assessment. If you have severe, sudden or worsening symptoms, seek medical advice promptly.