The quick answer

Match treatment to how painful and stiff the shoulder is now.

Frozen shoulder usually improves over time, but the process can take months and sometimes years. Early care often focuses on pain control and comfortable movement; later rehabilitation can progressively work on mobility and strength. Physiotherapy, medication and a steroid injection may each have a role. More invasive procedures are generally considered only when substantial symptoms persist despite appropriate non-surgical care.

Understanding the condition

What is a frozen shoulder?

Frozen shoulder—also called adhesive capsulitis—is a condition in which the capsule around the ball-and-socket shoulder joint becomes painful and progressively restricted. It can begin without an obvious injury, or follow a period when the arm has moved less after injury or surgery.

It is more common in people with diabetes and is also associated with some thyroid and metabolic conditions. These associations do not mean that everyone with a frozen shoulder has an underlying disease, but relevant health history forms part of a careful assessment. Read the 2025 BESS pathway.

Symptoms and diagnosis

What does frozen shoulder feel like?

The two central features are pain and stiffness. Pain may be strong at night and can disturb sleep. Everyday tasks such as fastening clothing, reaching a shelf, putting on a coat or placing a hand behind the back become difficult as movement reduces.

  • 01
    Painful phase

    Pain can dominate and movement may become progressively more limited. The shoulder may be highly irritable, particularly at night or after reaching.

  • 02
    Stiff phase

    Pain may begin to ease while restriction remains marked. External rotation—turning the forearm away from the body—is commonly limited.

  • 03
    Recovery phase

    Movement and function gradually return. These phases often overlap and do not follow a precise timetable.

Frozen shoulder restricts both the movement you produce yourself and the movement available when the arm is moved for you. Rotator-cuff pain, arthritis, a tendon tear and pain referred from the neck can produce overlapping symptoms, so stiffness alone is not enough to make the diagnosis.

Clinical assessment and imaging

Do you need a scan?

Frozen shoulder is primarily a clinical diagnosis based on the history and examination. An X-ray may be used when arthritis or another bone or joint problem is suspected. Ultrasound or MRI can help evaluate other soft-tissue conditions in selected cases, but imaging should support—not replace—the clinical assessment.

The 2025 non-surgical guideline recommends using ultrasound and MRI as adjuncts rather than independent diagnostic tests. Read the guideline. A scan is most useful when it answers a specific question that could change the management plan.

A staged approach

What treatment can help a frozen shoulder?

Keep the shoulder moving within a tolerable range

The NHS advises gentle movement rather than keeping the shoulder completely still. Early exercises may use short, comfortable ranges and simple assisted movements. As pain settles, mobility and strengthening can progress. Forceful stretching into severe pain is not automatically better and may aggravate an irritable shoulder. Read the NHS advice.

Use pain relief to support sleep and activity

Heat and appropriate medication may help some people manage pain and continue everyday movement. Painkillers and anti-inflammatory medicines are not suitable for everyone, so check with a pharmacist, GP or prescribing clinician if you are unsure or have other health conditions.

Make physiotherapy specific to the presentation

Physiotherapy may combine education, home exercise, movement practice, manual therapy and progressive strengthening. The useful dose depends on irritability and goals. A 2023 review found low-to-very-low certainty evidence and no clear optimal dosage for manual therapy or exercise, so treatment should not be sold as one universal protocol. Read the systematic review.

A possible addition

When may a steroid injection be considered?

An intra-articular corticosteroid injection may reduce pain and improve movement, particularly when pain is prominent and limiting sleep or rehabilitation. It is an option to consider—not a guaranteed cure—and its purpose should be clear, such as creating a more manageable window for movement and exercise.

Suitability depends on the working diagnosis, symptom pattern, diabetes control, medicines, infection risk, previous injections and wider health. Expected benefits, uncertainty, risks and alternatives should be discussed before any procedure. Where accurate joint placement is clinically important, ultrasound guidance may be considered by an appropriately trained clinician.

Learn about steroid injection consultations in Hull .

Persistent symptoms

What if physiotherapy and an injection are not enough?

Hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release are among the options discussed in specialist care. They differ in invasiveness, anaesthetic requirements, recovery and risk, and none is automatically the right next step for every person.

The UK FROST trial compared structured physiotherapy with a steroid injection, manipulation under anaesthesia, and arthroscopic capsular release in secondary care. At 12 months, all three pathways had improved outcomes and none was clearly clinically superior on patient-reported pain and function. The surgical pathway carried higher risks and costs, while the physiotherapy pathway led to more additional treatment. Read the NIHR summary.

These results support shared decision-making: consider symptom severity, previous care, health, personal preferences and the trade-offs of each option rather than assuming that surgery must be better because it is more invasive.

Recovery and safety

How long does recovery take—and when should you seek help?

The NHS notes that frozen shoulder can take months or years to improve. Progress is not always linear, and pain can ease before full movement returns. Useful markers include better sleep, easier dressing, increased comfortable reach and a gradual return of strength and confidence.

Arrange an assessment if pain and stiffness are persistent, worsening or severely limiting use of the arm. Earlier review is sensible after trauma, when there is marked weakness rather than stiffness alone, or when numbness, neck symptoms or systemic illness suggest another cause.

Seek urgent medical advice

Urgent assessment is appropriate for sudden severe pain after injury with deformity or inability to use the arm; a hot, red and swollen shoulder with fever or illness; chest pain or shortness of breath; or sudden neurological symptoms such as significant arm weakness or widespread numbness.

Frozen shoulder assessment in Hull

How Resolve MSK Clinic approaches shoulder pain and stiffness

We begin by confirming whether the pattern fits frozen shoulder and checking for other possible sources of pain or restriction. The plan is then matched to the current balance of pain and stiffness, your sleep and daily difficulties, health history and goals.

Management may include education, an individual movement and strengthening programme, advice on symptom control and, where appropriate, a discussion about injection options or further referral. Learn more about shoulder pain treatment in Hull, private physiotherapy and musculoskeletal assessment at Resolve.

Common questions

Frozen shoulder FAQs

How do I know if I have a frozen shoulder?

Frozen shoulder typically causes both pain and a marked loss of movement, including when someone else tries to move the shoulder. External rotation is often particularly restricted. Other shoulder conditions can look similar, so the diagnosis should be based on a clinical assessment rather than symptoms or a scan alone.

Should I push through painful frozen-shoulder exercises?

Not automatically. Gentle movement is usually encouraged, but forceful stretching into high pain can aggravate an irritable shoulder. Exercise intensity and range should reflect the level of pain, stiffness and next-day response, then progress as the shoulder becomes less reactive.

Can a steroid injection cure frozen shoulder?

No treatment can promise a cure. A steroid injection may reduce pain and improve movement, particularly when pain is prominent, and may make rehabilitation easier. Benefit varies and the risks, alternatives and wider plan should be discussed before treatment.

How long does frozen shoulder last?

Recovery is variable and often measured in months rather than weeks; for some people it takes years. Many improve substantially, but the timetable is not perfectly predictable and some people retain symptoms or restriction for longer.

Evidence used

Sources and further reading

Published 15 September 2026. Sources checked 15 September 2026. Review due September 2027, or sooner if relevant guidance changes. This article provides general information and does not replace an individual medical or physiotherapy assessment.

By Kenneth Mgbakogu, Musculoskeletal Physiotherapist and Independent Prescriber at Resolve MSK Clinic.