A frozen shoulder, also known as adhesive capsulitis, develops when the shoulder’s connective tissue becomes inflamed. As a result, the connective tissue thickens, leading to pain and stiffness that limits upper arm movement. 

Though a frozen shoulder can be frustrating and painful, understanding what causes it and how to manage it can help you navigate the healing process. A combination of physical therapy and following your provider’s advice should allow you to gradually regain full shoulder movement and resume your normal daily activities.

Full recovery from a frozen shoulder can take as little as a few months to as long as three years. It takes patience to completely heal the condition and regain full mobility in your shoulder.

Defining a Frozen Shoulder

To diagnose a frozen shoulder, your provider will conduct a physical examination by moving your arm and shoulder to see where it’s painful. You may also need X-rays or other imaging tests.

A frozen shoulder typically progresses through three stages:

1. Freezing stage: You start to experience pain, and your range of motion in your shoulder begins to decrease.
2. Frozen stage: Pain may decrease, but the shoulder becomes stiffer, making it difficult to move the joint.
3. Thawing, or unfreezing, stage: Shoulder movement gradually returns.

Causes of a Frozen Shoulder

The exact cause of a frozen shoulder isn’t always clear, but certain factors increase the risk of developing it. Immobilization due to an injury, surgery or another shoulder condition – like rotator cuff issues – can cause frozen shoulder. Other risk factors include:

• Age and gender: Frozen shoulder is more common in people ages 40 to 60 and affects more women than men.
• Diabetes: People with diabetes are more likely to develop frozen shoulder, though the reason for this is not well understood.
• Other health conditions: Heart disease, Parkinson's disease and thyroid disorders have also been associated with a higher risk of developing frozen shoulder.

Unfreezing a Frozen Shoulder

There’s no instant cure for a frozen shoulder, but these treatment options can help you manage symptoms and speed up the recovery process:

• Heat and stretching. Applying moist heat to your shoulder before stretching can help relax the muscles and connective tissue.
• Hydrodilation. An injection of sterile fluid to loosen the joint can be helpful.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as ibuprofen, can help manage pain and reduce inflammation.
• Physical therapy. Involving a series of range-of-motion exercises that stretch the joint capsule and improve shoulder movement, physical therapy can be a very effective means of treating a frozen shoulder.
• Steroid injections. Corticosteroid injections can reduce pain and inflammation, allowing you to engage more effectively in physical therapy.
• Surgery. In severe cases where physical therapy and other treatments fail, surgery may be recommended.