Frozen shoulder

What frozen shoulder is

Your shoulder joint sits inside a bag of soft tissue called the capsule. In frozen shoulder, the capsule becomes inflamed, then thickens and tightens. This causes pain and makes the shoulder stiff, so you can't move it far, even when someone else tries to move it for you.

It is most common between the ages of 40 and 60, and in women more than men. You are more likely to get it if you have:

diabetes
a thyroid problem
heart disease, or have had a stroke
Dupuytren's contracture (tightening in the palm of the hand)
had a shoulder injury or operation, or had to keep your arm still for a while

For many people, though, there is no clear reason. It is not caused by anything you did wrong.

Types of frozen shoulder

Doctors usually describe frozen shoulder in one of two ways.

Primary frozen shoulder

Also called idiopathic. It comes on for no known reason. This is the most common type.

Secondary frozen shoulder

It develops after something else, such as a shoulder injury, an operation, a period with your arm in a sling, a stroke or heart disease.

Frozen shoulder with diabetes

Frozen shoulder is more common in people with diabetes. It can be slower to get better, is more likely to come back, and is more likely to affect both shoulders.

Symptoms and how it progresses

The main symptoms are pain and stiffness. The pain is often worse at night and when lying on that side. Frozen shoulder usually goes through three stages, which can overlap.

2 to 9 months

Freezing

Pain builds up, often badly. Movement slowly gets less. Sleep is often disturbed.
4 to 12 months

Frozen

The pain often eases, but the shoulder stays stiff and may get stiffer. Reaching behind you or turning the arm outwards is hard.
12 to 42 months

Thawing

Movement slowly comes back. Pain and stiffness fade, often to normal or near normal.
Long term

Afterwards

Most people recover well. Some keep mild stiffness or pain for years. It can later affect the other shoulder.

Timings are typical ranges from NHS patient leaflets, not exact rules. Everyone's shoulder is different.

When to get urgent help

Frozen shoulder itself is not an emergency. But shoulder pain can sometimes be a sign of something more serious.

Call 999 if you have

sudden shoulder or arm pain with chest pain, tightness or pressure
shoulder pain with breathlessness, sweating or feeling sick
a shoulder that looks out of place after a fall or injury
sudden weakness or numbness in the arm, face or one side of the body

Call NHS 111 if

your shoulder is hot, red and swollen
you have shoulder pain with a high temperature or feel shivery and unwell
you can't move your arm at all after an injury
the pain is very bad and painkillers aren't helping

See your GP if

pain and stiffness haven't improved after 6 weeks of self-help
it is getting worse, or stopping you sleeping or working
you have a lump, or unexplained weight loss
you have diabetes and new shoulder pain

Diagnosis and referral

A GP or physiotherapist can usually diagnose frozen shoulder by asking about your symptoms and gently moving your arm. A key sign is that the arm won't turn outwards, even when someone else moves it for you.

You may have an X-ray to rule out other causes, such as arthritis. Because frozen shoulder is linked with diabetes, your GP may also check your blood sugar.

In many areas you can refer yourself to NHS physiotherapy, or see a physiotherapist at your GP surgery without seeing a GP first. Ask your surgery what's available. If pain stays severe or movement doesn't improve, you can be referred to a shoulder specialist or an orthopaedic team for injections or surgery.

6 weeks

NHS advice is to see a health professional if your shoulder hasn't started to improve after about 6 weeks of looking after it yourself. Don't wait if the pain is stopping you sleeping or working.

Treatments and medicines

Treatment aims to control pain while the shoulder recovers, then to get movement back. What helps most depends on your stage. In the painful freezing stage, pain relief and gentle movement matter most. Hard stretching too early can make it worse.

Simple painkillers

From a pharmacy or supermarket

Paracetamol first. Anti-inflammatory painkillers such as ibuprofen may help too, as tablets or gels. Taking them regularly can make it easier to move and sleep. Ask a pharmacist if they are safe for you.

Stronger painkillers

Prescription

Your GP may prescribe something stronger for a short time if simple painkillers aren't enough. These are not meant for long-term use because of side effects.

Steroid injections

GP, physiotherapist or specialist

An injection into the shoulder can calm inflammation and ease pain, especially in the early, painful stage. It doesn't cure frozen shoulder, but it can make exercises easier. The shoulder can be sore for a day or two before it helps.

Physiotherapy

NHS, often by self-referral

Gentle stretches, strengthening and posture advice, plus exercises to do at home. A course usually lasts at least 6 weeks, depending on how you progress.

Heat or cold

At home

A heat pack for up to 20 minutes can ease pain and help you move. Some people find an ice pack wrapped in a towel helps more. Protect your skin.

Specialist treatment and surgery

If pain or stiffness doesn't improve, a specialist may suggest one of these. They are usually tried in this order.

Hydrodilatation

About 15 minutes, as an outpatient

Also called hydrodistension. Using an ultrasound scan to guide the needle, a specialist injects salt water, a steroid and a local anaesthetic into the joint to stretch the tight capsule. You stay awake. You will need to do your exercises several times a day afterwards to get the full benefit. Don't drive yourself home.
Manipulation under anaesthetic

Usually a day case under general anaesthetic

While you are asleep, the surgeon moves your arm firmly to stretch and release the tight capsule. Physiotherapy afterwards helps keep the movement you gain.
Arthroscopic capsular release

Keyhole surgery, usually a day case

The surgeon cuts the tight capsule through 2 or 3 small cuts. Physiotherapy afterwards is important.

Surgery has risks. They include infection, nerve damage and fracture, though each is uncommon. Surgery doesn't always help: one NHS leaflet says it fails to improve symptoms in up to 3 in 10 people.

A large UK trial, UK FROST, compared early structured physiotherapy with a steroid injection, manipulation under anaesthetic, and keyhole surgery. After a year, people in all three groups had improved a lot, and the differences between them were small. Serious complications happened only in the surgery groups.

What UK FROST found at 12 months
Treatment	Anaesthetic	Result compared with physiotherapy
Early structured physiotherapy with a steroid injection	None	All groups improved a lot
Manipulation under anaesthetic	General	No real difference
Keyhole capsular release	General	Slightly better, but too small a difference to matter much, and it costs more

Self-help

When it is painful

Keep the shoulder moving gently, within what you can bear
Avoid movements that cause sharp pain
Take painkillers regularly if they help you move and sleep
Use heat or ice for short spells
Sleep with a pillow under the sore arm, or on your other side hugging a pillow

As it starts to ease

Do your physiotherapy exercises little and often
Build up stretches slowly. Stop if pain gets much worse
Keep items you use often at waist or chest height
Wear front-opening tops and put the sore arm in first
Keep doing the everyday things you can. Gradual use builds strength

Getting the best treatment

Before your appointment

Note when the pain started, how it has changed, and what makes it worse
Say how it affects your sleep, dressing, driving and work
Tell them if you have diabetes or a thyroid problem
Ask which stage they think you are in, and what that means for treatment
Ask whether you can refer yourself to physiotherapy
If treatment isn't working after a few months, ask about hydrodilatation or referral to a shoulder specialist

Keep a simple diary of pain, sleep and what you can and can't do. It helps your doctor see how things are changing, and it is useful evidence for your employer and for a funding application.

Frozen shoulder and work

Staying in work, or going back as soon as you can, often helps recovery. You don't need to be pain-free to return. Talk to your GP or physiotherapist about what's safe for your job.

Frozen shoulder can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland). This applies if it has more than a minor effect on your daily life and has lasted, or is likely to last, at least 12 months. Because frozen shoulder often lasts more than a year, many people will qualify. If it does, your employer must make reasonable adjustments. These might include:

A phased return, building up hours over a few weeks
Lighter duties, with no heavy lifting or overhead reaching
Moving things you use into easy reach
A sit-stand desk and a well-set-up workstation
A mouse or keyboard you can use with your other hand
A phone headset and voice recognition software
Regular breaks to move and stretch
Time off for physiotherapy and appointments

Your fit note can suggest a phased return, changed duties or adapted hours. Access to Work is a government grant in England, Scotland and Wales that can pay for equipment and support at work beyond what your employer must provide. For advice on your rights, contact Acas or Citizens Advice.

Benefits

If you are an employee and too unwell to work, you may get Statutory Sick Pay for up to 28 weeks. If frozen shoulder makes daily life hard for a long time, you may be able to get Personal Independence Payment (PIP), or Adult Disability Payment in Scotland, Universal Credit or Employment and Support Allowance. If it started after an accident at work, look at Industrial Injuries Disablement Benefit. Turn2us and Citizens Advice can help you check.

How The Beyond Pain Foundation can help

If NHS waits are too long, or the help you need isn't available to you on the NHS, we may be able to fund:

A course of private physiotherapy with a registered physiotherapist
A private consultation with a shoulder specialist
Hydrodilatation or a guided injection, when a specialist recommends it
Workplace or home equipment, such as a sit-stand desk, an ergonomic mouse and keyboard, or voice recognition software
Daily living aids, such as long-handled reachers or dressing aids

We can't pay for everyday living costs or debts. Prices for private treatment vary a lot, so always get a written quote to include with your application.

Apply for funding Check the requirements

Support and sources

Versus Arthritis

Information and support

Information on shoulder pain and frozen shoulder, exercises, and an online community.

versusarthritis.org

Pain Concern

Charity for people living with pain

Helpline 0300 123 0789. Leave a message and they will usually call back the next working day. Also leaflets and a peer support forum.

painconcern.org.uk

NHS

Health information

Symptoms, treatment and when to get help with frozen shoulder.

nhs.uk/conditions/frozen-shoulder

Sources for this guide

Last reviewed: October 2026.