Frozen Shoulder: Causes, Symptoms, and Treatments

Frozen shoulder (Adhesive capsulitis) is a painful, typically prolonged issue that requires proper management and clinical diagnosis. It happens in up to 5% of people, with women being four times more likely to get affected than men.

Also, the non-dominant shoulder seems to be more prone to developing this condition. If you are trying to wrap your mind around frozen shoulder pain, then you’ve come to the right place. This is where you can find a detailed guideline on what’s causing the problem, its signs, and opportunities for treatment. 

Frozen Shoulder – What Is It, Exactly?

Frozen shoulder is often described as an inflammatory, fibrotic contracture of the ligaments, capsule, and rotator interval. This is a painful condition that might for a long time, paired with poor range of motion and progressive stiffness. 

A frozen shoulder usually occurs in people in their 60s. But, it can also happen in patients younger than 40. This, however, is very uncommon. Research indicates that the peak age is 56. In 6% to 17% of patients, the pain can affect their other shoulder as well.


Experts are not aware of why some patients develop it. But, some are more prone to others. Different medical conditions can take a toll on your shoulder health, particularly in diabetic patients. Roughly 10% to 20% of diabetics get a frozen shoulder.

The plausible risk factors include:

● Cancer

● Diabetes mellitus (with up to 20% prevalence rate)

● Injured shoulder

● Thyroid disorder


● Parkinson’s 

● Dupuytren disease

● Complex regional pain syndrome

Now, when you look at the frozen shoulder causes, it’s important to talk about the structure of the shoulder. The tendons, ligaments, and bones make up the shoulder joint, and all of them stay in a capsule of connective tissue. When the capsule tightens and thickens around the joint, that’s when you experience a restricted joint movement. Thus, frozen shoulder develops.


The symptoms of a frozen shoulder are categorized into different clinical stages. Their impact will vary depending on what stage the condition is in, explains the National Institutes of Health. These four stages of frozen shoulder include:

●       I – Painful Stage: The first stage is characterized by movement reduction and moderate pain. The symptoms can last less than three months.

●       II – Freezing Stage: The second stage also causes movement reduction. But, the aches become worse, causing severe pain. These symptoms can stay from 3 to 9 months.

●       III – Frozen Stage: The third stage predominantly causes stiffness. Although pain can occur, stiffness dominates. These symptoms tend to affect the patient for 10 to 14 months.

●       IV – Thawing Stage: The fourth and final stage showcases gradual movement improvement. The pain also subsides. This can last 14 to 24 months.

So, what are early signs of frozen shoulder? Whenever you try to move the shoulder, you can feel pain. When paired with stiffness, regular shoulder movements become difficult to carry out. Many patients develop aches in their upper arm and can’t sleep on the side of the affected shoulder.


In most cases, conservative treatment is more than enough to curb the symptoms. OTC meds, like NSAIDs, can relieve shoulder inflammation and pain. If they don’t provide the necessary pain relief, doctors can prescribe stronger meds. 

But, sometimes, other approaches may be necessary. Treatment modalities for frozen shoulder include:

● Anti-inflammatory meds (i.e., ibuprofen, aspirin, Aleve, or Naprosyn)

Physiotherapy (shoulder stretches and exercises)

● Hydrodistension (also referred to as shoulder joint distension)

● Local steroid injection (cortisone injections for short-term relief)

● Manipulation under anesthesia (surgeons move the shoulder to work with the scar tissue and shoulder capsule)

● Open capsular release (minimally-invasive surgical procedure for restricted movement and pain relief)

● Arthroscopic capsular release (minimally-invasive surgery for loss of mobility and pain relief)

You may need to go to a physical therapist to do stretching and shoulder strengthening exercises. If the symptoms don’t improve after 3 to 6 months of conservative treatment, then doctors may recommend surgery. The primary goal is to ease pain and restore the patient’s range of motion.

People also want to know how to do a proper frozen shoulder treatment at home. Your main focus would be to avoid movements that aggravate the shoulder pain. Do gentle movements and use the prescribed meds when necessary. 

Doctors recommend painkillers since they can bring down discomfort and swelling. But, to keep your recovery on the right track, you would need to do regular shoulder exercises and stretch. Your doctor can suggest the best stretching methods you can use so that you can enjoy better pain relief.

Another important factor is to have good posture. If you are sitting and standing slumped forward, your posture will put a strain on your shoulders. Adequate spine alignments won’t stress the ligaments and joints. That’s why you should maintain a proper posture for better comfort. 


● What is the main cause of frozen shoulder?

After having suffered from a broken arm, shoulder injury, or stroke, you will need to rest for a very long time. This immobility, while you are still in recovery, is one of the main causes of a frozen shoulder. Talk to a specialist to decrease your odds of developing this problem.

● What is the best treatment for frozen shoulder?

Shoulder stretches and exercises will be your go-to choice. Depending on the level of discomfort, you may need to take adequate numbing medication. If you are having trouble curbing the inflammation, pain, and discomfort in your shoulder, talk to your doctor. Some patients need a surgical approach to loosen the joint capsule and restore their range of motion.

● Is the heat or ice better for frozen shoulder?

Frozen shoulder responds better to the cold rather than heat. Using cold therapy is a great way to ease inflammation, swelling, and aches. It can reduce the symptoms of this particular problem. However, don’t use cold directly on the skin. Take some ice packs, wrap them up in a towel and then apply them to the skin. When you use cold therapy, make sure you touch the area that is most affected.

● Is massage good for frozen shoulder?

Yes. Both massages and stretching can be highly beneficial for easing the aches from a frozen shoulder. Massages are a practical choice for releasing tightness and tension. They also help the shoulder function properly and restore its mobility. Sometimes massages can promote better circulation and curb inflammation.

● How long does a frozen shoulder take to heal?

It depends from person to person. But, you can expect this problem to take 1.5 to 3 years to improve. At times, it may take longer than that. Luckily the stiffness and pain and be managed and will eventually dissipate.

● How to sleep with a frozen shoulder?

Place a pillow below the affected arm and rest the hand on the stomach. Don’t put pressure on the affected shoulder. If you tend to roll in while sleeping, then put more pillows to make sure you don’t press on the frozen shoulder.