Have you noticed that your shoulder has become so stiff and painful that even simple tasks, such as brushing your hair, reaching into a cupboard, or putting on a jacket, feel almost impossible? If so, you may be dealing with frozen shoulder (also known as adhesive capsulitis).
This condition can feel frustrating, but you’re not alone. Frozen shoulder affects approximately 2–5% of adults, most commonly between the ages of 40 and 60. The good news is that with the proper care—especially physiotherapy—most people recover well.
In this post, we’ll explain in plain language what frozen shoulder is, what’s happening inside your joint, and how physiotherapy can help you get moving again. We’ll also touch briefly on medical treatments your doctor might suggest.
What Is Frozen Shoulder?
Your shoulder joint is surrounded by a flexible sleeve of tissue called the capsule. Think of it like a stretchy bag that allows your arm to move in all directions.
In frozen shoulder, this capsule becomes inflamed, thickened, and tight. Scar-like bands form, making the capsule shrink. The result? Pain, stiffness, and a significant loss of shoulder movement.
Why Does Frozen Shoulder Happen?
Sometimes, frozen shoulder develops after an injury or surgery when the shoulder hasn’t been moved for a while. But it can also appear without an obvious cause.
Certain health conditions increase your risk, such as:
- Diabetes
- Thyroid problems
- High cholesterol
Scientists are also finding that frozen shoulder is linked with the body’s immune system, stress, and metabolism. In other words, it’s not always just a shoulder problem—it can be influenced by your overall health.
What Does Frozen Shoulder Feel Like?
Frozen shoulder usually develops in three stages:
- Freezing stage – Pain starts and gets worse, especially at night. The shoulder becomes harder to move.
- Frozen stage – Pain may settle a little, but stiffness is at its worst. Everyday tasks are challenging.
- Thawing stage – The shoulder slowly starts to loosen, and movement gradually returns.
Without treatment, recovery can take 2 to 3 years, and some stiffness may remain. That’s why early treatment—especially physiotherapy—is so valuable.
How Physiotherapy Helps
Physiotherapy is one of the main treatments for frozen shoulder. Here are the approaches that research shows work best:
1. Supervised Exercise Programs
Exercise is the cornerstone of treatment. Regularly moving the shoulder helps reduce stiffness, improve range of motion, and alleviate pain. Working with a physiotherapist is often better than only doing exercises at home, because they can make sure you’re doing the correct movements safely.
2. Hands-On Therapy (Mobilisation)
Your physiotherapist may use gentle joint mobilisation techniques—hands-on movements that help loosen the capsule and improve motion. This is especially effective when combined with your exercise program.
3. Neuromuscular Exercise
This type of exercise retrains the muscles around the shoulder and shoulder blade to move in sync. It’s a bit like teaching your muscles to “work as a team” again, and can improve both movement and pain.
4. Self-Stretching (With Good Guidance)
Daily stretching at home is also essential—but only if it’s done correctly and consistently. Your physiotherapist will teach you safe stretches and ensure that you perform them in a way that helps, rather than irritates, your shoulder.
What About Medical Options?
Sometimes, your doctor may recommend additional treatments. These include:
Corticosteroid Injections
A corticosteroid injection into the shoulder joint can calm inflammation and provide short-term relief, making it easier for you to do your exercises. Injections alone are not the solution—they work best when combined with physiotherapy.
Manipulation Under Anaesthesia (MUA)
If the shoulder remains very stiff and painful despite months of physiotherapy and conservative care, your doctor may discuss manipulation under anesthesia (MUA).
This involves being put to sleep with anaesthesia while the doctor gently moves your shoulder through its range of motion to break up the tight capsule.
Research indicates that MUA can provide short-term improvements in movement and pain, particularly when followed by immediate physiotherapy. However, it carries risks such as fractures or soft-tissue injury, so it’s usually reserved for more stubborn cases.
⚠️ Important note: Both injections and MUA are medical procedures. Always consult your doctor to determine whether they are suitable for you, and weigh the benefits and risks.
Key Takeaways
- Frozen shoulder happens when the capsule around your joint thickens and tightens.
- It can last years if untreated, but physiotherapy speeds recovery.
- The most effective physiotherapy treatments are:
- Supervised exercise programs
- Manual therapy (mobilisation)
- Neuromuscular exercise
- Well-taught daily stretching
- Injections may reduce pain and allow better participation in physiotherapy.
- MUA can be considered for stubborn cases, but only after other treatments haven’t worked and with specialist guidance.
With the proper care plan and persistence, most people regain their shoulder mobility and return to the activities they love.