Frozen Shoulder is a condition, which as the name indicates, involves reduced movement of the shoulder after a period of severe pain. The condition is due to changes within the joint capsule involving inflammation followed by contracture. The cause of Frozen Shoulder remains largely unknown. It consists of four stages – painful stage, freezing stage, frozen stage and thawing stage. These stages can occur over the course of 1-4 years, with most cases returning to functional use of their shoulder. 

Initially patients will report a gradual onset of constant pain in the front and side of the shoulder, along with night pain. Sudden movements are often reported to cause severe pain. Gradually pain is reported to reduce and become intermittent, and night pain resolves. Stiffness then becomes the primary complaint with a noted loss of function.

Treatment varies according to which stage a client is diagnosed in, and may include Hydrodilatation. This is an injection of fluid into the shoulder capsule to stretch the joint. Your health professional can assist with the diagnosis and monitoring of stages, and provide appropriate education and treatment. 

This will likely involve some manual therapy, particularly within the later stages of Frozen Shoulder. An individualised exercise program will also be prescribed, focusing on the return of shoulder range and strength. 



Treatment options

Painful stage

gradual onset, severe pain, night pain

Education, pain relief medication, steroid injection, avoid stretching

Freezing stage

pain reducing, stiffness increasing

Pain relief, moderate stretching and exercise, Hydrodilatation injection

Frozen stage

minimal pain, stiff++

Stretch and exercise level can increase, Hydrodilatation injection

Thawing stage

gradual return of range

Stretch and exercise to return to normal function