Frozen Shoulder

What is frozen shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain, stiffness and limited movement in your shoulder. Symptoms usually appear gradually and worsen over time. This pain can last for one to three years if left untreated. While it can resolve on its own, the process is slow, and everyday activities like reaching, lifting, or sleeping comfortably can become difficult.

At Novant Health, we understand how frustrating shoulder pain and restricted movement can be. Our team is here to help you understand your condition, explore treatment options and regain comfort and mobility.

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Diagram comparing a normal shoulder and a frozen shoulder, showing adhesions.

Shoulder anatomy

The shoulder is a ball-and-socket joint formed by the upper arm bone (humerus) and the shoulder blade (scapula). Smooth cartilage covers the ends of these bones, allowing the joint to move freely while absorbing stress. The joint is surrounded by a capsule lined with synovium, which produces fluid to reduce friction.

In a healthy shoulder, cartilage and synovial fluid work together to provide smooth, pain-free motion. With arthritis, cartilage gradually thins or disappears, and inflammation of the joint lining may develop. In advanced stages, bone may rub directly against bone, significantly limiting movement and increasing pain.

Overview

Symptoms

Frozen shoulder typically develops in three stages, each lasting several months:

Freezing Stage: pain occurs with any shoulder movement, and your range of motion gradually decreases. Pain at night is common and can disrupt sleep.
Frozen Stage: pain may decrease, but stiffness increases. Your shoulder may feel “locked,” making daily tasks challenging.
Thawing Stage: shoulder movement slowly returns, though full mobility can take time to regain.

You may notice difficulty reaching overhead, behind your back, or performing simple tasks like combing your hair. In some cases, imaging such as X-rays or an MRI may be ordered to rule out other conditions.

Causes

Your shoulder joint is made up of bones, tendons, and ligaments, all encased in a capsule of connective tissue. Over time, this capsule gradually thickens and tightens, restricting movement. The exact cause isn’t fully understood, but certain factors can increase your risk, including:

Diabetes

Extended periods of immobilization following a fracture, injury, or shoulder surgery

Being a woman

Being over the age of 40

The condition develops slowly, which means it can be easy to dismiss early discomfort but recognizing the signs early can make treatment more effective.

Diagnosis

Your doctor will evaluate how far you can move your shoulder both actively (on your own) and passively (when assisted by the doctor). Sometimes, an anesthetic injection may be used to help assess range of motion without pain.

Accurate diagnosis ensures that your symptoms aren’t caused by other shoulder conditions, such as rotator cuff injuries or arthritis.

Why treatment matters

Even though frozen shoulder may eventually improve on its own, untreated stiffness can last months to years and affect your quality of life. Early treatment helps:

Reduce pain and inflammation

Restore shoulder mobility faster

Prevent further stiffness

Improve your ability to perform daily activities

At Novant Health, our approach focuses on personalized care, guiding you through therapies that match your stage of recovery and your comfort level.

Treatment Options

Treatment for frozen shoulder often begins with conservative, non-surgical methods, including:

Pain-relieving medications

Ice or heat therapy

Physical therapy exercises to gently stretch and strengthen the shoulder

Acupuncture

Steroid injections or joint capsule injections to reduce inflammation and loosen stiffness

For more persistent cases, your doctor may recommend procedures such as shoulder manipulation under anesthesia or minimally invasive surgery to remove scar tissue and adhesions. Surgery is rarely necessary but may be considered when other treatments do not provide relief.

Take the next step

Our board-certified specialists are here to help you heal. They can often diagnose the problem in one visit and get you started with a personalized treatment plan. We offer a wide variety of treatment options.