Frozen Shoulder: Symptoms, Stages and How Long It Lasts

The main symptoms of frozen shoulder (adhesive capsulitis) are a deep, aching shoulder pain and stiffness that keeps getting worse, until the arm will not move far in any direction, even when someone else tries to move it for you. Reaching behind your back and turning the arm outward are usually the first movements lost. Pain is often worse at night. The condition tends to pass through three overlapping phases and often lasts one to three years in total.

Frozen shoulder happens when the capsule, the tough lining around the ball-and-socket joint, becomes inflamed, then thickens and tightens. It is most common between about 40 and 60, more common in women, and more common in people with diabetes or thyroid disease. Often there is no clear injury.

Most people regain much of their movement over time. Some are left with a small amount of stiffness that rarely gets in the way of daily life.

Key takeaways

Main symptoms: a deep shoulder ache, night pain, and stiffness in every direction, even when the arm is moved for you.
First movements lost: usually turning the arm outward and reaching behind the back.
Three phases: freezing (pain rising), frozen (stiffness at its worst), and thawing (movement slowly returning).
Total length: often one to three years from first symptoms to the end of the thawing phase.
Who it affects: most often people aged about 40 to 60, more often women and people with diabetes or thyroid disease.

Where are you right now?

It has just started: read the freezing phase in the month-by-month section, and “Where else this could be coming from”, since several shoulder problems look alike early on.
Months in and not settling: go to “Is this normal?” and “If it isn’t going to plan”. The stiff months are a separate stage from the painful months.
After an injection or procedure: a steroid injection or a stretching procedure (hydrodilatation or release under anesthetic) changes the timeline. Follow your doctor’s plan for the weeks after.
Getting back to work or sport: the “When can I…” table gives typical ranges by activity.

Month by month

The phases overlap and their length varies a great deal from person to person. These are typical ranges.

Freezing phase, often lasting 2 to 9 months: pain builds, often at night and with sudden movements. Movement starts to go, first behind the back and turning the arm outward. Many people assume a strain that should settle in a few weeks.
Frozen phase, often lasting 4 to 12 months: pain usually eases, especially at rest and at night. Stiffness is at its worst. Getting dressed, doing up a bra, reaching a back pocket and washing your hair are hard.
Thawing phase, often lasting 6 months to 2 years or more: movement slowly returns. Progress is measured in weeks and months, not days.
Two to three years: many people have most of their movement back. Some keep a small amount of stiffness, usually in turning the arm outward or reaching up behind the back.

Where else this could be coming from

Early frozen shoulder can be hard to tell apart from other causes of shoulder pain. These are the common ones and what tends to set them apart.

Rotator cuff problems (tendinopathy or a tear): lifting the arm yourself is painful or weak, but someone else can often move it further. In frozen shoulder, the arm is stiff whoever moves it.
Shoulder arthritis: stiffness and grinding, usually in older adults, with changes in the joint that show on an X-ray. Frozen shoulder usually has a normal X-ray.
Calcific tendinitis: a sudden, very severe shoulder pain from a calcium deposit in a tendon, often visible on an X-ray or ultrasound.
The neck: pain on top of the shoulder or across the shoulder blade that changes with neck movement, sometimes with tingling into the arm. Shoulder movement is often not limited.
The heart, lungs or gallbladder: shoulder pain that comes with chest pain, breathlessness, sweating, or pain after fatty meals, and that does not change when you move the arm. Chest symptoms are an emergency.

Is this normal?

“It is worse at night.” Night pain is very common in the freezing phase. Lying on the other side with a pillow hugged to the chest, or lying on your back with a pillow under the arm, helps many people.
“The pain has eased but I still cannot move it.” This is the usual shift from freezing to frozen. Less pain with more stiffness is expected in the middle months.
“A quick, unexpected movement makes me catch my breath.” Sharp pain at the end of the available range, such as reaching to catch something, is common. It usually settles within minutes.
“It is taking so long.” One to three years is a typical total. Slow progress in the frozen phase does not mean it will not thaw.
“Now the other shoulder aches.” Some people develop frozen shoulder on the second side, often months or years later. It is uncommon in the same shoulder twice.

Less pain with more stiffness is often a sign the shoulder has moved into the next phase.

If it isn’t going to plan

It is month five. You still cannot reach the seatbelt with that arm, and you have stopped wearing anything that fastens at the back. The thought in your head is that you just need to push through the stretches harder, or stop moving it altogether until it calms down.

Both instincts tend to backfire. In the painful months, forcing the stretch usually irritates an inflamed capsule and the shoulder answers with a worse night. Keeping the arm still lets the stiffness set in further. The capsule needs a different dose at each phase.

While it is painful, gentle movement inside the comfortable range, done often, keeps what you have without stirring it up. Pain relief, and sometimes a steroid injection, can make this phase easier to get through. Once pain settles, firmer stretching held for longer becomes useful, and strengthening helps the arm use the movement as it returns.

If you are months in and the night pain is not easing, or movement has stopped improving, get assessed by a physical therapist or your doctor. Useful questions to ask:

Phase: which phase do you think I am in, and how should my exercises change because of it?
Measurement: how will we measure my movement so we can see progress?
Other conditions: should my blood sugar or thyroid be checked?
Other options: would an injection or hydrodilatation suit me, and at what point?

When can I…

Activity	Typical range
Sleep on that side	Often not comfortable until the frozen or thawing phase, many months in
Drive	Usually possible throughout if you can steer and reach the seatbelt safely; some people adjust how they reach
Reach overhead	Often limited for many months; usually returns gradually in the thawing phase
Lift	Light loads close to the body usually manageable; lifting above shoulder height often limited until thawing
Desk work	Usually possible throughout, with the keyboard and mouse close so the arm stays by your side
Manual work or sport	Overhead work and throwing or racquet sports often limited until well into the thawing phase

If you have had surgery, your surgeon’s protocol comes first.

Call your local emergency number or go to the emergency department if

Chest symptoms: shoulder pain, especially on the left, comes with chest pain or pressure, breathlessness, sweating, nausea, or pain in the jaw.
Injury: the shoulder looks out of shape after a fall or blow, or you cannot move it at all after an injury.
Sudden breathlessness: shoulder or upper back pain comes with sudden breathlessness or pain on breathing in.

See a doctor today if

Hot, swollen joint: the shoulder is hot, red or swollen, or you have a fever.
Diabetes: you have diabetes and your blood sugar has risen sharply alongside new shoulder pain.
Arm changes: the arm becomes swollen, discolored or cold, or numbness spreads down it.

Get it checked soon if

No diagnosis yet: a stiff, painful shoulder has not been assessed and is not clearly easing after about 2 to 4 weeks.
Night pain: pain still wakes you most nights after several months.
Weight loss or illness: you have unexplained weight loss, a history of cancer, or feel generally unwell.
Movement stalled: movement has not improved at all over several months in the later phases.