Frozen shoulder — medically known as adhesive capsulitis — is one of the more frustrating conditions we treat, mostly because it tends to get worse before it gets better, and recovery can take considerably longer than most patients expect. Understanding its three distinct stages can make the process far less confusing.
Stage 1: Freezing
This is the painful stage, typically lasting anywhere from 6 weeks to 9 months. Pain gradually increases, and shoulder movement becomes progressively more limited — often worse at night, making sleep difficult.
Stage 2: Frozen
Pain usually starts to ease during this stage, but stiffness remains — sometimes even more pronounced. Everyday tasks like reaching overhead, fastening a bra, or reaching into a back pocket become genuinely difficult. This stage can last 4 to 12 months.
Stage 3: Thawing
Shoulder motion gradually returns, though this can be a slow process spanning 6 months to 2 years. Most patients do regain the majority of their movement, though a small number are left with some residual stiffness.
What actually helps
Physiotherapy remains the backbone of treatment throughout all three stages, with the specific exercises adjusted depending on which stage you're in. Anti-inflammatory medication helps manage pain during the freezing stage. For patients whose stiffness isn't resolving on its own, a manipulation under anaesthesia or an arthroscopic capsular release can help speed things along.
Setting realistic expectations
The single most important thing to understand about frozen shoulder is that it is, by nature, a slow process. Patience — combined with consistent physiotherapy — genuinely is a large part of the treatment, alongside any medical intervention needed for pain relief.
