How long does frozen shoulder last?

What is frozen shoulder?

Frozen shoulder, also called adhesive capsulitis, is a condition in which the flexible tissue surrounding the shoulder joint, the capsule, becomes inflamed, thickened and tight. The result is pain and a gradual loss of movement in every direction, particularly turning the arm outwards and lifting it overhead.

It most often affects people in middle age and is more common in people with diabetes and thyroid disorders. It can also follow a period of reduced shoulder movement, for example after an injury or surgery, although in many people there is no clear trigger.

What are the stages of frozen shoulder?

Frozen shoulder is traditionally described in three overlapping phases. In the painful or freezing phase, pain builds up, often worse at night, and movement starts to reduce. In the frozen phase, pain gradually settles but stiffness is at its greatest. In the thawing phase, movement slowly returns.

These phases are a useful description, but they do not follow a fixed timetable, and not everyone moves neatly from one to the next. A clinical practice guideline on adhesive capsulitis describes how symptoms and irritability change over time and how treatment should be matched to them 1.

Does frozen shoulder get better on its own?

For decades, frozen shoulder was described as self-limiting, with full recovery expected without treatment. A systematic review that examined this belief found low-quality evidence that people who received no treatment improved partly, but not completely, over one to four years 2. It found no evidence supporting progression through phases to full resolution, and moderate-quality evidence that most improvement occurred early rather than late 2.

In practice, this means many people do improve, but waiting passively does not always lead to complete recovery, and a proportion keep some stiffness or discomfort for years.

Which treatments help frozen shoulder?

The guideline recommends explaining the natural course of the condition, stretching and mobility exercises pitched at a level the shoulder can tolerate, and joint mobilisation. It also supports intra-articular corticosteroid injections combined with mobility exercises, which can provide short-term pain relief and allow easier movement, particularly in the painful phase 1.

When the shoulder is very painful, gentle movement within comfort is more helpful than forceful stretching, which can flare pain. As irritability settles, stretching can progress in intensity and duration.

When are procedures or surgery considered?

If significant stiffness and pain continue despite several months of appropriate treatment, other options may be discussed. These include hydrodilatation, in which fluid is injected into the joint to stretch the capsule, manipulation under anaesthesia and keyhole surgery to release the tight capsule.

These procedures carry their own risks and are usually reserved for people who have not improved enough with non-surgical care. Rehabilitation is still needed afterwards to keep the movement gained.

What can I do at home?

Keep the arm moving within a comfortable range through the day, for example with pendulum swings, supported arm lifts using the other arm or a stick, and gentle outward rotation. Heat before exercise may ease stiffness. Short, frequent sessions are often easier than long ones.

At night, supporting the arm on a pillow can reduce pain. People with diabetes may find that good blood sugar control helps overall health during recovery.

When should shoulder pain be checked by a doctor?

Loss of movement after a fall or injury, a shoulder that looks deformed, severe pain with fever, redness or swelling, or pain with chest discomfort or breathlessness need prompt medical assessment.

Stiffness that develops gradually should be assessed to confirm the diagnosis, as other problems such as arthritis or a rotator cuff tear can look similar and are managed differently.

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