Adhesive capsulitis (frozen shoulder)

Frozen shoulder is a stiff, painful shoulder caused by tightening of the joint capsule. It often progresses through freezing, frozen, and thawing stages over months.

What it feels like

Global loss of motion is the hallmark, especially external rotation and reaching behind the back.

Pain can be intense in the freezing stage, including night pain, then stiffness becomes the dominant complaint.

Simple tasks like fastening a bra, reaching a seatbelt, or washing hair become surprisingly hard.

What is going on

The capsule becomes inflamed and contracted. Diabetes and thyroid disease raise risk, and idiopathic cases are common.

Unlike many cuff problems, passive motion is limited early, not just active strength.

Natural history often improves over time, but waiting without a plan can mean a long, frustrating year.

How we evaluate

We document active and passive range carefully and screen the neck and cuff.

X-rays help exclude other bony causes of stiffness. MRI is used when the diagnosis is uncertain.

Staging (pain-predominant vs stiffness-predominant) guides how aggressive we are with injections and stretching.

What we may offer

Education on the expected course, pain-calming strategies, and careful mobility work are foundational.

Image-guided glenohumeral corticosteroid injection can help selected freezing-stage patients engage in rehab.

Refractory stiffness may lead to discussion of more advanced procedures with surgical colleagues.

How long does frozen shoulder last?

It can unfold over many months. Staging and treatment aim to shorten the difficult parts and protect function.

Is frozen shoulder the same as a rotator cuff tear?

No. Frozen shoulder is capsule stiffness. Cuff tears are tendon injuries. They can occasionally overlap.

Should I push hard through stretching?

Aggressive stretching in a highly inflamed freezing stage can backfire. We match intensity to the stage.

Do injections help frozen shoulder?

An intra-articular steroid injection can help some people, especially when pain blocks rehab progress.