Frozen shoulder is a condition where the capsule around the shoulder joint becomes inflamed, thickened and tight, causing pain and a marked loss of movement. It often starts with a painful phase and is followed by a stiff phase. Many people improve over time, but recovery can take a long while and some are left with mild stiffness.
Also known as adhesive capsulitis, stiff shoulder
Symptoms
- Shoulder pain that often comes on gradually with no clear cause
- Pain that is often worse at night and disturbs sleep
- Stiffness in all directions, especially turning the arm outwards
- Difficulty with everyday tasks such as dressing, doing up a bra or reaching a high shelf
- Pain easing over time while stiffness remains, before movement slowly returns
Causes and risk factors
- Most often no clear cause is found
- Diabetes, which raises the risk
- Thyroid problems
- A period of shoulder immobility, for example after injury or surgery
- Being aged roughly 40 to 60
What the evidence says helps
- A steroid injection into the shoulder joint appears to give the best short-term pain relief and improvement in function, based on a large 2020 review.3
- Adding a home exercise programme and physiotherapy-type care to an injection may give extra benefit over the following months.35
- A Cochrane review found manual therapy and exercise alone may not work as well as a steroid injection in the short term. The evidence is limited, so these are often used together.5
- In the UK FROST trial, early structured physiotherapy with a steroid injection, manipulation under anaesthetic and keyhole capsular release all led to similar results at one year. Capsular release carried more risk.4
- Recovery times vary and can be measured in years. Some people are left with some pain or stiffness.2
Things you can try at home
- Keep the shoulder moving gently within what you can tolerate. Forcing painful stretches in the early stage can make it worse.
- Use pain relief, heat or ice to help you sleep and keep active.
- Adapt daily tasks, for example using the other arm for reaching.
- If you have diabetes, keep in touch with your GP or diabetes team about blood sugar control.
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A hot, red, swollen shoulder with fever or feeling generally unwell: get same-day help from your GP or NHS 111, as this can signal a joint infection.
- Shoulder pain that comes with chest pain, tightness, breathlessness, sweating or feeling sick: call 999, as this can be a heart problem.
- Shoulder pain with unexplained weight loss, a new lump, or a past history of cancer: see your GP urgently.
- A visible deformity, severe pain or being unable to move the arm after a fall or blow: go to A&E or an urgent treatment centre.
- Severe stiffness after a fall in an older adult: get an X-ray to rule out a fracture or dislocation, which can look like frozen shoulder.
How Apollo can help
We assess your shoulder carefully to check whether the picture fits frozen shoulder or another cause, and explain the likely course so you know what to expect. Our osteopaths and exercise team offer hands-on care where appropriate and a staged exercise plan that matches how irritable your shoulder is. If an injection or specialist opinion may help, we will discuss this with you and write to your GP.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
How long does frozen shoulder last?
It varies a lot between people. Recovery can take many months or even years, and some people are left with mild stiffness or pain. Treatment aims to ease pain and keep you functioning while it settles.
Will a steroid injection help frozen shoulder?
Research suggests a steroid injection into the joint gives the best short-term pain relief, especially in the early painful stage. Combining it with exercise may help further. Your GP or a specialist can talk you through the risks and benefits.
Do I need surgery for frozen shoulder?
Most people do not. A large UK trial found that surgery did not lead to clinically better results at one year than early physiotherapy with a steroid injection. Surgery may be considered when symptoms persist despite other treatment.
References
- Brealey S et al. (2020). Surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder: the UK FROST three-arm RCT. Health Technology Assessment. View source
- Karbowiak M et al. (2022). Frozen shoulder. BMJ. View source
- Challoumas D et al. (2020). Comparison of treatments for frozen shoulder. JAMA Network Open. View source
- Rangan A et al. (2020). Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, three-arm, superiority randomised clinical trial. The Lancet. View source
- Page M et al. (2014). Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database of Systematic Reviews. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
