Understanding Frozen Shoulder: What You Need to Know

By Professor Bijayendra Singh, FRCS (T&O) FRCS MS (Ortho) DNB (Ortho) PG Dip (Ortho)
Orthopaedic Upper Limb Consultant, LycaHealth Orpington and KIMS Hospital

Frozen shoulder, medically known as adhesive capsulitis, is a condition I frequently encounter in my practice. It can be frustrating for patients because it often develops gradually, sometimes without a clear trigger, and can take months (sometimes upto 3 years) to resolve. Many people delay seeking help, thinking the pain will settle on its own, only to find that everyday activities become increasingly difficult. In this blog, I’ll explain what frozen shoulder is, why it happens, how to recognise the symptoms, and the treatment options available to help you regain movement and reduce pain.

What is Frozen Shoulder?

Frozen shoulder occurs when the capsule surrounding the shoulder joint becomes inflamed and stiff. This leads to pain, limited range of motion, and difficulty with daily tasks. Patients often describe a “deep ache” or throbbing pain in the shoulder, which is usually worse at night. Simple activities such as reaching overhead, fastening clothes, or even combing your hair can become challenging.

The shoulder is one of the most mobile joints in the body, and when it becomes restricted, it can have a significant impact on daily life. Frozen shoulder can affect one or both shoulders, though it usually starts on one side.

Who Gets Frozen Shoulder?

While frozen shoulder can affect anyone, there are certain patterns and risk factors:

• Age group: Most common between 40 and 60 years.
• Gender: Slightly more frequent in women.
• Medical conditions: People with diabetes or thyroid disorders are at higher risk.
• Injury or surgery: A previous shoulder injury or surgery can increase susceptibility.

It’s important to recognise these risk factors, as early intervention can improve outcomes and reduce the duration of symptoms.

The Three Phases of Frozen Shoulder

Frozen shoulder generally progresses through three phases, though the timeline can vary from person to person. These phases may overlap, and not everyone experiences them in a predictable order:

1. Freezing phase: Pain gradually increases, often interfering with sleep and daily activities. Movement becomes more restricted during this stage.
2. Frozen phase: Pain may reduce slightly, but stiffness is at its worst. Daily activities become difficult, and the shoulder may feel “locked.”
3. Thawing phase: Range of motion slowly improves. Recovery can be gradual, taking months to years if left untreated.

Overall, the condition can last anywhere from 18 to 36 months without intervention. During the freezing phase, pain tends to dominate, whereas in the frozen phase, stiffness is the main complaint, although some pain may still persist.

Treatment Options for Frozen Shoulder

The good news is that frozen shoulder can be managed effectively. Treatment depends on the severity, duration, and impact on daily life. Options include:

• Physiotherapy: Gentle exercises help maintain movement and gradually restore mobility. While some exercises may temporarily increase discomfort, physiotherapy is crucial for long-term recovery.
• Injections: Corticosteroid injections can reduce inflammation and pain, particularly in the early stages.
• Hydrodilatation (Hydrodistension): This procedure involves gently stretching the shoulder capsule using a sterile fluid. In appropriate cases, it can provide significant improvement in pain and movement.
• Keyhole surgery (arthroscopic release): In cases resistant to non-surgical treatment, particularly in the frozen phase, this minimally invasive procedure releases the tight capsule, allowing faster recovery and improved mobility.

When to Seek Help

Persistent shoulder pain or stiffness should not be ignored. Early assessment allows for quicker intervention, often preventing prolonged disability. If you notice:

• Increasing shoulder pain at night
• Difficulty reaching above your head or behind your back
• A gradual or sudden loss of shoulder movement

…it’s worth booking an appointment with an orthopaedic specialist. Prompt treatment can significantly shorten recovery time and reduce long-term complications.

Living with Frozen Shoulder

Managing frozen shoulder can be challenging, both physically and emotionally. Pain can interfere with sleep, work, and hobbies, while restricted movement can affect independence. Keeping up with prescribed exercises, attending physiotherapy sessions, and following your treatment plan are essential. Support from family and friends, as well as guidance from your healthcare team, can make a real difference.

Why Choose LycaHealth Orpington

At LycaHealth Orpington and KIMS Hospital, Maidstone, I offer a full range of diagnostic and treatment options for shoulder problems, including frozen shoulder. With advanced techniques such as hydrodilatation and keyhole surgery, we provide targeted, effective care tailored to each patient. My goal is to help you regain pain-free movement and return to your daily activities as quickly as possible.

For patients with frozen shoulder or other upper limb conditions, early consultation is the best step towards recovery. With personalised treatment, expert care, and evidence-based approaches, it is possible to overcome the limitations of this condition and get back to the activities you enjoy.

Final Thoughts

Frozen shoulder is a common but treatable condition. By recognising the symptoms early, understanding the phases, and accessing the right treatment, you can significantly improve your quality of life. Whether through physiotherapy, injections, hydrodilatation, or surgical intervention, there are effective options to restore mobility and reduce pain.

If you are experiencing persistent shoulder pain or stiffness, do not wait. Book a consultation at LycaHealth Orpington or KIMS Hospital to discuss the best approach for your situation. Our team is here to support you through every step of your recovery.

Professor Bijayendra Singh
FRCS (T&O) FRCS MS (Ortho) DNB (Ortho) PG Dip (Ortho)
Orthopaedic Upper Limb Consultant
KIMS Hospital & LycaHealth Orpington

Specialising in shoulder, elbow, wrist, and hand problems, Professor Singh offers expert assessment, personalised management, and advanced surgical techniques for a wide range of upper limb conditions.