Frozen Shoulder (Adhesive Capsulitis): Symptoms, Causes & PT Treatment
Updated October 20261 minute read
Frozen shoulder is when the joint capsule tightens and inflames, causing pain and a major loss of motion in every direction — you may struggle to reach overhead, behind your back, or out to the side. It typically moves through painful "freezing," stiff "frozen," and "thawing" stages over many months. It usually recovers, and physical therapy helps manage pain and restore motion along the way.
What is frozen shoulder?
Also called adhesive capsulitis, frozen shoulder involves thickening and tightening of the capsule that surrounds the shoulder joint. The hallmark is loss of motion that affects even movements someone else tries to do for you.
Symptoms
It usually progresses in stages: a painful freezing phase (aching, often worse at night), a stiff frozen phase (pain eases but motion is very limited), and a gradual thawing phase as motion returns. Reaching behind your back and overhead is especially hard.
What causes it / risk factors
The exact trigger isn't always clear. Risk is higher with diabetes and thyroid conditions, and it can follow a period of shoulder immobility (after injury or surgery). It's most common in adults 40–60.
How it's diagnosed
Diagnosis is clinical — the pattern of global motion loss is distinctive. Imaging mainly rules out other causes.
Physical therapy treatment
What a PT does. Your therapist matches treatment to the stage: calming pain early, then progressively restoring motion and strength as the shoulder allows. Exercises & progression (overview). Gentle range-of-motion and stretching matched to irritability, progressing to strengthening. Pushing too hard during the painful phase can backfire, so dosing matters. Recovery timeline. Frozen shoulder is slow — often many months to a couple of years — but most people regain good function.
Treatment options compared
PT is central throughout. Injections can help pain in the early phase. Procedures to free the capsule are reserved for stubborn cases.
Red flags
Seek care for sudden inability to move the arm after trauma, a hot feverish joint, or arm pain with chest symptoms (emergency).
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Frequently asked questions
Often many months to two years through its stages, though PT can ease symptoms along the way.
Sources (5)
- Kelley MJ, et al. Shoulder pain and mobility deficits: adhesive capsulitis. Clinical practice guideline. J Orthop Sports Phys Ther. 2013. — PubMed
- OrthoInfo (AAOS): Frozen Shoulder (Adhesive Capsulitis). — AAOS OrthoInfo
- MedlinePlus: Frozen shoulder. — NIH/MedlinePlus
- Challoumas D, et al. Comparison of treatments for frozen shoulder: a systematic review and network meta-analysis. JAMA Netw Open. 2020. — JAMA Netw Open
- Rangan A, et al. Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, randomised controlled trial. Lancet. 2020. — Lancet
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.