Overview
Adhesive capsulitis (frozen shoulder) is a painful condition of the shoulder in which the joint capsule becomes inflamed and then stiffens over time. The stiffness limits how far the shoulder can move, which is why it can feel like the arm is "stuck" even when you try to move it. Pain and loss of motion can affect everyday tasks such as reaching overhead, reaching behind the back, dressing, and driving. Most cases improve with time, and nonsurgical care is usually the first step to control pain and restore movement.
Symptoms
The most noticeable symptom is progressive shoulder pain along with a major loss of both active and passive range of motion, especially external rotation and reaching behind the back. Pain is often felt in the front and side of the shoulder and may worsen at night, disrupting sleep. Activities that require lifting the arm overhead or rotating the shoulder tend to be the hardest. Over time, the stiffness can limit dressing, personal hygiene, and work or household tasks that involve reaching or carrying.
Causes
Adhesive capsulitis happens when the shoulder joint capsule and surrounding tissues become inflamed and then tighten, restricting normal sliding of the joint. In many people, the exact trigger is not identified, but it can follow shoulder injury, surgery, or prolonged shoulder immobility. The condition can also arise "spontaneously," where inflammation develops without a clear single event.
Risk Factors
Risk is higher in people with diabetes, and it can also be associated with thyroid disorders and other medical conditions. Frozen shoulder is more common in middle-aged and older adults, and it often affects one shoulder first. Previous shoulder injury, surgery, or a period of reduced movement can increase the likelihood of developing it. Hormonal and inflammatory tendencies may also contribute in some cases.
Prevention
You may reduce risk by avoiding long periods of shoulder immobility after injury and by resuming gentle, pain-guided motion as directed by a clinician. Managing underlying conditions such as diabetes and thyroid disease can help lower the chance of developing frozen shoulder or worsening stiffness. If you have shoulder pain, early evaluation and a structured mobility plan can help prevent the problem from progressing. Staying active with regular overall conditioning may also support joint health and function.
How the Diagnosis Is Evaluated
Clinicians typically diagnose adhesive capsulitis through a detailed history and a focused physical examination that checks shoulder motion. A key finding is that both active movement (what you do) and passive movement (what the examiner does) are limited in a characteristic pattern, particularly external rotation. Imaging such as X-ray or ultrasound or MRI is not always necessary, but it may be ordered to rule out other causes of pain and stiffness like arthritis, rotator cuff tears, or other structural problems. In some cases, diagnostic injections or additional testing may be used when the picture is atypical.
Nonsurgical Treatment Options
Treatment focuses on reducing pain first and then restoring shoulder motion through a gradual, structured program. Physical therapy and home exercises commonly emphasize gentle stretching and mobility work within tolerable discomfort to improve range of motion over time. Anti-inflammatory or pain medications such as NSAIDs, along with heat therapy and activity modification, can help you participate more effectively in rehabilitation. A corticosteroid injection into the joint or around the capsule can reduce inflammation and pain and may improve motion in the short term, especially when combined with therapy. Some patients may benefit from joint distension (capsular stretching) performed by trained clinicians. For selected cases, clinicians may discuss adjunct options such as PRP injections or hyaluronic acid injections, but these are variable and should be considered carefully; trigger point injections can help if myofascial pain contributes, while adipose allograft or stem cell injections are generally considered experimental and not standard care.
When to Seek Medical Attention
Seek medical attention if you have rapidly worsening shoulder stiffness, significant nighttime pain, or a marked loss of shoulder motion that interferes with daily activities. Prompt evaluation is also appropriate if the shoulder problem followed a recent injury, or if you cannot lift or use the arm as expected. Urgent care is needed for severe weakness, fever with a hot/swollen joint, sudden deformity, or symptoms of nerve problems such as progressive numbness or uncontrolled tingling. Seek urgent evaluation immediately if you have chest pain or shortness of breath along with shoulder/arm discomfort, as this can indicate a non-shoulder cause.
Frequently Asked Questions
Frozen shoulder often improves gradually over months, but the full course can take a year or longer in some people.
Many cases are diagnosed clinically, and imaging is typically used to rule out other conditions when symptoms are atypical or progress is poor.
Next Steps
If your shoulder has become progressively stiff with both active and passive movement limits, schedule an evaluation with a clinician who can perform a focused shoulder exam. Early nonsurgical treatment is often most effective at controlling pain and starting the motion-recovery process. If you have sudden severe weakness, fever, or rapidly worsening symptoms, seek urgent medical care right away.