Shoulder conditions
Frozen shoulder
A painful, progressive stiffening of the shoulder, frustrating but almost always recoverable, usually without surgery.
Adhesive capsulitis
Resolves over time
Rarely needs surgery
What is frozen shoulder?
Frozen shoulder, or adhesive capsulitis, is an inflammation and tightening of the capsule that surrounds the shoulder joint. The capsule thickens and contracts, sharply limiting motion.
It classically moves through three phases, a painful freezing phase, a stiff frozen phase, and a gradual thawing phase. The whole process can take many months to a couple of years, but it almost always resolves.
Overview
At a glance
Patience pays off
Frozen shoulder is one of the few shoulder problems that reliably gets better on its own. Treatment is aimed at controlling pain and speeding the return of motion.
Symptoms & signs
How frozen shoulder feels
The hallmark is stiffness that limits motion in every direction.
A deep, aching pain, often worst early in the condition
Progressive stiffness that limits reaching in all directions
Difficulty with dressing, grooming, and reaching behind the back
Pain that disturbs sleep, especially lying on that side
A shoulder that feels mechanically stuck
Causes & risk factors
What triggers it
Often it appears for no clear reason, but several factors raise the risk.
Diabetes
People with diabetes are significantly more likely to develop frozen shoulder.
Immobilization
A period of not moving the arm, after injury or surgery, can trigger it.
Age and sex
Most common between 40 and 60, and more frequent in women.
Unknown cause
Many cases are idiopathic, arising with no identifiable trigger.
Treatment options
How frozen shoulder is treated
Nearly all cases improve with non-surgical care and time; surgery is a last resort.
- A guided stretching and physical therapy program
- Anti-inflammatory medication for pain
- A corticosteroid injection to calm inflammation
- Hydrodilation to gently stretch the capsule in select cases
- Manipulation under anesthesia to free the capsule
- Arthroscopic capsular release for stubborn cases
- Reserved for the small number who do not improve
- Followed by intensive therapy to keep the motion gained
Related procedure
In the rare case that stiffness does not resolve, a manipulation or arthroscopic capsular release is discussed, see the overview of the surgical process.
Recovery
What recovery looks like
Recovery is gradual but dependable, measured in months.
Control pain
Treatment focuses on calming the painful, inflamed phase.
Maintain motion
Stretching preserves and slowly expands the available range.
Regain reach
Motion steadily returns as the capsule loosens.
Back to normal
Most people regain full, comfortable use of the shoulder.
FAQ
Common questions
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Yes, the overwhelming majority of cases resolve completely with time and therapy, though it can take many months.
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Gentle, consistent stretching helps, but aggressive forcing can worsen the inflammation. Dr. Cohn and your therapist guide the right intensity.
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Very rarely. Surgery is only considered for the small number of shoulders that stay stiff despite months of dedicated therapy.
Related procedures