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Have you been feeling a nagging pain in your shoulder, accompanied by a stiffness that just won’t go away? You might be dealing with something called “frozen shoulder.”

Often, it pops up more in people who haven’t moved their shoulder much after an injury or surgery.  Sometimes it can happen out of the blue with no injury at all.  Also, frozen shoulder is more likely to happen in middle age and in people with other chronic health problems.

That said, frozen shoulders can happen in active and healthy people, too.

What Is a Frozen Shoulder?

A frozen shoulder happens when the connective tissue around the shoulder joint thickens and tightens. Doctors don’t know exactly why this happens, but not moving the shoulder enough can make people more prone to it.

Frozen shoulder symptoms are more likely to develop after an injury or surgery that causes a person to restrict their shoulder movement.

The tightening and thickening happen gradually. This process is often painful.

A frozen shoulder will usually get better, and it’s not a sign of a major illness.

Once the shoulder is fully “frozen,” the pain often reduces or goes away. But the tightness and stiffness can remain, making shoulder movement very limited.

Frozen shoulder symptoms can take anywhere from one to three years to resolve, according to the American Academy of Orthopaedic Surgeons.

Over time, the muscles and ligaments around the shoulder joint become less inflamed and tight. Most people get their full range of motion back, but 10% of people continue to have some limited motion in the shoulder.

A frozen shoulder typically occurs on only one side. But people who get a frozen shoulder are at a higher risk of getting a frozen shoulder on the other side later.

Frozen Shoulder Symptoms

The main symptoms of a frozen shoulder are:

• Difficulty rotating the shoulder outward (turning the arm away) or inward (trying to get your arm up your back).
• Inability to lift the arm out to the side or above the head.
• Neck pain (this is because the neck muscles may work harder with a frozen shoulder).
• Pain in the shoulder, especially with movement.
• Stiffness in the shoulder.

Usually, pain and stiffness start slowly and get more frequent and more severe over weeks to months. During the “frozen stage,” the pain starts to go away, but the stiffness remains. Then, there’s a thawing stage, lasting many months to years, where the motion gradually comes back.

Having a frozen shoulder can make it difficult to do day-to-day tasks, including getting dressed and bathing.

One tell-tale frozen shoulder symptom is that the stiffness doesn’t just happen when you try to move your shoulder yourself. When a health provider tries to move the shoulder joint (called passive range of motion), movement is also limited.

How Do Health Providers Diagnose a Frozen Shoulder?

In many cases, a health provider can diagnose a frozen shoulder by asking about symptoms and doing a physical exam. The health provider will move the shoulder joint in a passive way.

If the provider thinks there may be another cause, like a rotator cuff tear or arthritis, they will order more tests. Imaging like a simple x-ray, MRI, or ultrasound can confirm or rule out these other possible diagnoses.

How Is a Frozen Shoulder Treated?

Health providers treat frozen shoulders with physical therapy, medications, steroid injections, and, in rare cases, surgery.

Physical therapy

This is the main treatment for frozen shoulder. Your health provider or a physical therapist can teach you exercises to do at home that will loosen the shoulder joint over time. The focus of therapy is frequent stretching.  It’s important you do the exercises on a daily basis.

Medication

When pain is severe, you can take non-steroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen (sold under brands Advil, Mortin, and others) and naproxen (sold under Aleve and other brands). Your doctor can tell you the dosage of NSAIDs you should take, and how often, as these medications aren’t safe for everyone.

Steroid injections

Another treatment option is steroid injections in the shoulder. This anti-inflammatory medication can improve pain and stiffness. Your health care provider can discuss with you the number and frequency that you can receive an injection.

Surgery

Rarely, frozen shoulder symptoms don’t get better over time, despite pain medication and physical therapy. Surgery can help in these cases.

While the person is under anesthesia (asleep), the surgeon will either make small cuts in the shoulder muscle (camera surgery called an arthroscopic capsular release) or stretch it manually (called a manipulation under anesthesia). This increases the range of motion in the shoulder.

Following surgery, it is critical that continued physical therapy and stretching exercises are performed daily for a number of weeks to maintain motion that is gained at the time of surgery.

Other treatment options

Some people find acupuncture and massage therapy also help with frozen shoulders. Getting good sleep, eating well, avoiding smoking, and limiting alcohol all help healing.

Who Is Most Likely to Get Frozen Shoulder?

Women are four times as likely as men to get frozen shoulder. This problem most often occurs in one’s 40s to 60s.

The following health problems can increase the risk of a frozen shoulder. However, healthy people can get frozen shoulder as well without these medical issues:

• A previous stroke.
• A previous surgery or injury that requires the shoulder to be still for a long time.
• Cervical disc disease of the neck.
• Diabetes.
• Parkinson’s disease.
• Thyroid problems.

While a lack of motion can cause the shoulder muscles to stiffen, it’s not clear why certain health problems increase the risk. Researchers have simply noticed higher rates of frozen shoulders in people with these problems.

How Can I Prevent a Frozen Shoulder?

The best way to prevent a frozen shoulder is to do shoulder stretches every day. You can look up examples online or ask your physical therapist to show you.

It is especially important to do shoulder stretching on the other shoulder so that you don’t develop a frozen shoulder on the opposite shoulder. People who get frozen shoulder on one side have a 15% chance of getting it on the other side within five years. That’s according to a 2024 review published by the National Institutes of Health.

If you have diabetes, you can prevent frozen shoulder by keeping your blood sugars under control. Also, take your medications as directed.

How Long Will It Take My Frozen Shoulder to Get Better?

Studies show that it can take two years and four months, on average, for frozen shoulders to resolve. That’s from when frozen shoulder symptoms first start to when the problem is fully better.

But frozen shoulders can take shorter or longer to get better. The time for improvement can be significantly shortened with the treatments recommended above, particularly with daily stretching. People with diabetes can take longer to recover.

Keeping to your physical therapy routine, eating healthy, and sleeping well will speed up your recovery time.

To learn more or schedule an appointment, visit UPMC Orthopaedic Care.