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DNPR — Dr Nasir Physiotherapy & Rehabilitation

Shoulder Orthopaedic Rehabilitation

Frozen Shoulder

  • Progressive loss of shoulder movement
  • Severe pain at night, often preventing sleep
  • Difficulty reaching behind the back or overhead
  • Both active and passive movement restricted
Anatomical illustration of the shoulder, with the painful joint highlighted

Quick answer

Frozen shoulder is inflammation and thickening of the shoulder joint capsule, causing progressive stiffness and severe night pain. It passes through freezing, frozen and thawing stages over roughly one to two years. Treatment is matched to the stage: pain relief early, aggressive stretching later.

Typical recovery

Stage-dependent; typically 12–24 months in total

A typical range, not a promise — how long it takes depends on how long it has been going on, and on what you do between appointments.

Frozen shoulder, or adhesive capsulitis, is one of the few musculoskeletal conditions with a genuinely predictable course. The capsule surrounding the shoulder joint becomes inflamed and then thickens and contracts, and the joint loses movement in every direction — including when someone else moves the arm for you. That last point is what distinguishes it from most other shoulder problems.

The three stages

Freezing (roughly 2–9 months). Pain dominates and worsens. Night pain is often severe enough to prevent sleep. Movement is progressively lost.

Frozen (roughly 4–12 months). Pain settles considerably, but stiffness is at its worst. Reaching behind the back, fastening a bra, or getting a wallet from a back pocket becomes impossible.

Thawing (roughly 5–24 months). Movement gradually returns.

Why the stage matters more than anything else

Aggressive stretching during the freezing stage makes pain and inflammation worse and can prolong the whole condition. The same stretching during the frozen stage is exactly what is needed. Treatment that ignores the stage is the most common reason people feel physiotherapy "did not work" for their frozen shoulder.

How physiotherapy helps

  • Freezing: pain control, gentle movement within a comfortable range, sleep positioning advice, and keeping the rest of the shoulder girdle working
  • Frozen: sustained stretching, joint mobilisation at end range, and a home stretching programme done several times daily
  • Thawing: progressive strengthening to rebuild the muscle lost over months of disuse

Where night pain is unmanageable, a corticosteroid injection during the freezing stage can help considerably, and we will say when we think it is worth discussing with a doctor.

Who gets it

It is more common between 40 and 60, in women, and substantially more common in people with diabetes — where it also tends to be more stubborn. It can follow a period of immobilisation after injury or surgery.

How long it takes

Most cases resolve over one to two years. Well-directed physiotherapy does not eliminate the timeline but reliably improves the range regained and reduces how much function is lost along the way.

Medically reviewed by Nasir Mughees, BPT, MPT, Orthopaedic Physiotherapy · Last reviewed September 2026

Frequently asked questions

Why does my shoulder hurt so much at night?
Night pain is characteristic of the freezing stage — the inflamed capsule is compressed when you lie on it or let the arm fall across the body. Sleeping on the other side with a pillow supporting the affected arm usually helps.
Should I push through the pain to stretch it?
Not during the freezing stage — aggressive stretching then worsens inflammation and can prolong the condition. In the frozen stage, firm stretching is appropriate and necessary.
Why is frozen shoulder more common in diabetes?
The connective tissue changes associated with long-term raised blood glucose appear to predispose the capsule to it. It is both more common and typically more stubborn in people with diabetes.

Others in shoulder

  • Assessment before every plan
  • 10 qualified therapists
  • 52,883 sessions in the last year
  • Centre & home visits
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