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Frozen Shoulder

What is a Frozen Shoulder?

A frozen shoulder is a painful condition which occurs when there are changes to the shoulder capsule (the lining that surrounds the shoulder joint). These changes restrict the normal movement and make tasks, such as dressing and brushing your hair, difficult and painful to do. Typically, pain can be felt in the outer shoulder and into the upper arm.

The exact cause of a frozen shoulder is not always known. A primary frozen shoulder occurs for no apparent reason and a secondary frozen shoulder can occur after an injury, surgery or periods of immobilisation. Individuals who also have diabetes, heart disease, thyroid problems and are aged between 40-60 are more at risk of developing a frozen shoulder.

How long will it last?

Typically a frozen shoulder has three overlapping phases:

Stage 1. The shoulder becomes very painful and progressively loses range of movement. The pain tends to be constant, regardless of whether you are moving or resting the shoulder and sleep is often disturbed. This stage may last between 2-9 months

Stage 2. Pain starts to ease and is generally only felt when the arm has reached the end of its available range movement. Considerable stiffness in the joint remains. This stage may last between 4-12 months.

Stage 3. Shoulder movement starts to improve and pain continues to reduce. This stage may last between 12-42 months

What can I do to help myself?

In the early stages of a frozen shoulder treatment is focused on pain relief and reducing specific tasks that aggravate the symptoms.

  • Stay positive, for most people, time is all that is needed for a frozen shoulder to resolve (see the times suggested above)
  • Try using heat or ice packs, applied to the shoulder to help manage the pain ( ensure the pack is wrapped in a towel and check the skin regularly for signs of burns).
  • Reduce or change any specific activities that aggravate your symptoms but do not stop completely.
  • Use regular pain relief in the form of paracetamol or ibuprofen (please check with a pharmacist to ensure these are safe for you). For some individuals stronger pain relief is required and you would need to discuss this with your GP. A steroid injection may also be used to help control the pain. This can be discussed with your GP or physiotherapist, but is generally only used when other medications have been tried unsuccessfully.
  • Self-refer to see a physiotherapist.

What will physiotherapy do?

A physiotherapist will take a thorough history of your symptoms and will conduct a physical examination of the area to confirm the diagnosis.

In the early stages only gentle exercises would be recommended and treatment remains focused on pain relief, advice and education. Often trying to force the shoulder to move in the painful stages can just make it more painful and is not beneficial.

Once stiffness is more of a problem than pain, physiotherapy focuses on stretches to regain normal shoulder movement and strength. We have included some exercises for you to try:

Frozen Shoulder Easy Exercises

Frozen Shoulder Moderate Exercises

Frozen Shoulder Advanced Exercises

Acupuncture, electrotherapy and massage have not been shown to be effective for frozen shoulders and is therefore not offered as a treatment.

Symptoms to check

Click the plus sign to see a list of problems that could be a sign you may need to be checked urgently

Get advice from 111 now if:

  • the pain is sudden or very bad
  • you cannot move your arm
  • your arm or shoulder has changed shape or is badly swollen
  • you have pins and needles that do not go away
  • your arm or shoulder is hot or cold to touch
  • the pain is severe and started after an injury or accident, like a fall
  • hurts when you exercise but goes away when your rest
  • you are experiencing chest pain/tightness with your shoulder pain

111 will tell you what to do. They can tell you the right place to get help if you need to see someone.

Go to 111.nhs.uk or call 111.

Immediate medical advice is available by contacting NHS 111

Exercises & Resources area

If you have already received a diagnosis from a medical professional you may find some the following links helpful:

Referral information

If your shoulder pain persists then you can self-refer to see a physiotherapist who can help diagnose your problem and guide you on how best to help recovery.