Table of ContentsView AllTable of ContentsPre-FreezingFreezingFrozenThawingTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Pre-Freezing
Freezing
Frozen
Thawing
Treatment
Prognosis
The four stages of frozen shoulder include pre-freezing, freezing, frozen, and thawing. These terms describe the typical progression of the condition from early symptoms to recovery.
A frozen shoulder, also called adhesive capsulitis, is a very common cause ofshoulder pain. Frozen shoulder can take a long time to heal, anywhere from six months to 2 years.
This article goes over the four stages of frozen shoulder, how long they typically last, and what you can do to relieve pain. It also discusses the prognosis for someone who has frozen shoulder.
aldomurillo / Getty Images
Stage 1: Pre-Freezing (1 month to 3 months)
Pre-freezing describes the earliest stage of frozen shoulder. This is when you first start to notice pain in your shoulder.Many people in this stage will first notice the pain at night while changing positions in bed.
As the condition progresses, you may notice pain when you move your shoulder, especially when raising the arm or reaching behind you. You may also find that you have reduced mobility in that shoulder. It may ache even when you are not using it.
Because motion may be only slightly restricted in this stage, early frozen shoulder can be mistaken for a problem with therotator cuff.
What is the root cause of frozen shoulder?Frozen shoulder happens when there is inflammation in the tissue that surrounds the shoulder joint. Although the specific causes of frozen shoulder aren’t known, immobilization after an injury and other conditions of the shoulder like bursitis may play a role.
What is the root cause of frozen shoulder?
Frozen shoulder happens when there is inflammation in the tissue that surrounds the shoulder joint. Although the specific causes of frozen shoulder aren’t known, immobilization after an injury and other conditions of the shoulder like bursitis may play a role.
Stage 2: Freezing (10 weeks to 8 months)
Stage 3: Frozen (4 months to 12 months)
The third phase of a frozen shoulder is known as the frozen phase. During this phase, the shoulder is notably stiff.
The characteristicexamination findingthat confirms the diagnosis of a frozen shoulder is that neither the patient or another person can move the shoulder.
With a rotator cuff problem, often a patient can’t move their arm normally, but their healthcare provider can. This helps distinguish between frozen shoulder and a rotator cuff injury.
The frozen phase is typically much less painful than the freezing phase, but pain can result from seemingly simple activities.Rotation of the shoulder joint is particularly limited, making activities such as washing hair, hooking a bra, or reaching for a seat belt painful or difficult.
Stage 4: Thawing (5 months to 2 years)
In this phase, the capsule of the shoulder joint has become thickened and stiff, but over time it gradually loosens.It is important tostretch the shoulder capsule, even allowing for some discomfort, in order to ensure the shoulder joint mobility continues to recover.
Not having the extreme pain associated with the freezing of the joint, and seeing gradual gains in mobility make this phase tolerable, albeit frustrating and long.
Treatment of Frozen Shoulder
Frozen shoulder treatmentis almost always best accomplished with physical therapy and stretching of the joint. Anti-inflammatory medications,ice and heat application, and alternative therapies can all be helpful in managing the discomfort. Your healthcare provider may also recommend a corticosteroid injection to help reduce inflammation. This can help reduce pain and improve mobility quicker.
Surgery can be an option for treating a frozen shoulder, but it is seldom needed. It is usually only considered if prolonged efforts at therapy have failed to improve symptoms.
One of the problems with surgery for treatment of frozen shoulder is that surgery is a possible cause of frozen shoulder.Therefore, it’s possible for some patients to get worse after surgery.
The timeline for recovery from a frozen shoulder can be long and frustrating. It’s important for patients to understand that no matter what, the recovery time is measured in months, if not years.Expecting a quick recovery causes more frustration.
That said, there are steps you can take to speed your recovery and reduce the discomfort of a frozen shoulder. Physicaltherapy can be beneficial, and your healthcare provider can suggest treatments to help alleviate pain while you recover.
The good news is, over time, almost all patients will find complete relief of pain, and normal ornear-normal range of motionof the shoulder joint.
Summary
Frozen shoulder is a condition that causes severe pain and limited mobility in the shoulder. It progresses through four stages and can take up to two years to completely resolve.
Recovering from a frozen shoulder is a long process, typically requiring ongoing physical therapy. Surgery may be considered if physical therapy doesn’t seem to be helping, but this is uncommon.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Soussahn S, Hu D, Durieux J, Kosmas C, Faraji N.Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support.Curr Probl Diagn Radiol. 2024;S0363-0188(24)00048-3. doi:10.1067/j.cpradiol.2024.03.005Chan HBY, Pua PY, How CH.Physical therapy in the management of frozen shoulder.Singapore Med J. 2017;58(12):685–689. doi:10.11622/smedj.2017107Johns Hopkins Medicine.Frozen shoulder.UpToDate.Patient education: Frozen shoulder (beyond the basics).Redler LH, Dennis ER.Treatment of adhesive capsulitis of the shoulder.J Am Acad Orthop Surg. 2019;27(12):e544-e554. doi:10.5435/JAAOS-D-17-00606Le HV, Lee SJ, Nazarian A, Rodriguez EK.Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments.Shoulder Elbow. 2017;9(2):75-84. doi:10.1177/1758573216676786Additional ReadingAmerican Academy of Orthopaedic Surgeons, OrthoInfo.Frozen shoulder.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Soussahn S, Hu D, Durieux J, Kosmas C, Faraji N.Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support.Curr Probl Diagn Radiol. 2024;S0363-0188(24)00048-3. doi:10.1067/j.cpradiol.2024.03.005Chan HBY, Pua PY, How CH.Physical therapy in the management of frozen shoulder.Singapore Med J. 2017;58(12):685–689. doi:10.11622/smedj.2017107Johns Hopkins Medicine.Frozen shoulder.UpToDate.Patient education: Frozen shoulder (beyond the basics).Redler LH, Dennis ER.Treatment of adhesive capsulitis of the shoulder.J Am Acad Orthop Surg. 2019;27(12):e544-e554. doi:10.5435/JAAOS-D-17-00606Le HV, Lee SJ, Nazarian A, Rodriguez EK.Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments.Shoulder Elbow. 2017;9(2):75-84. doi:10.1177/1758573216676786Additional ReadingAmerican Academy of Orthopaedic Surgeons, OrthoInfo.Frozen shoulder.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Soussahn S, Hu D, Durieux J, Kosmas C, Faraji N.Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support.Curr Probl Diagn Radiol. 2024;S0363-0188(24)00048-3. doi:10.1067/j.cpradiol.2024.03.005Chan HBY, Pua PY, How CH.Physical therapy in the management of frozen shoulder.Singapore Med J. 2017;58(12):685–689. doi:10.11622/smedj.2017107Johns Hopkins Medicine.Frozen shoulder.UpToDate.Patient education: Frozen shoulder (beyond the basics).Redler LH, Dennis ER.Treatment of adhesive capsulitis of the shoulder.J Am Acad Orthop Surg. 2019;27(12):e544-e554. doi:10.5435/JAAOS-D-17-00606Le HV, Lee SJ, Nazarian A, Rodriguez EK.Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments.Shoulder Elbow. 2017;9(2):75-84. doi:10.1177/1758573216676786
Soussahn S, Hu D, Durieux J, Kosmas C, Faraji N.Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support.Curr Probl Diagn Radiol. 2024;S0363-0188(24)00048-3. doi:10.1067/j.cpradiol.2024.03.005
Chan HBY, Pua PY, How CH.Physical therapy in the management of frozen shoulder.Singapore Med J. 2017;58(12):685–689. doi:10.11622/smedj.2017107
Johns Hopkins Medicine.Frozen shoulder.
UpToDate.Patient education: Frozen shoulder (beyond the basics).
Redler LH, Dennis ER.Treatment of adhesive capsulitis of the shoulder.J Am Acad Orthop Surg. 2019;27(12):e544-e554. doi:10.5435/JAAOS-D-17-00606
Le HV, Lee SJ, Nazarian A, Rodriguez EK.Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments.Shoulder Elbow. 2017;9(2):75-84. doi:10.1177/1758573216676786
American Academy of Orthopaedic Surgeons, OrthoInfo.Frozen shoulder.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
