How long does frozen shoulder last? The 3 stages and what helps

What is frozen shoulder?

Frozen shoulder (adhesive capsulitis) is when the capsule around the shoulder joint becomes inflamed, then thickened and tight. It usually comes on without any obvious injury, although it can follow an injury or surgery that has stopped you moving your arm normally (NHS, 2024).

In a UK study of 223 people, the average age when symptoms started was 53, and women were affected more often than men (Hand et al., 2008). The clearest risk factor is diabetes. Around 13% of people with diabetes develop frozen shoulder, roughly five times the rate in people without it, and around 30% of people with frozen shoulder have diabetes (Zreik, Malik and Charalambous, 2016). It is also linked with thyroid problems (Kean Ann Phua et al., 2025).

That diabetes link is worth acting on. If you have been told you have frozen shoulder and have never had a blood sugar check, it is reasonable to ask your GP for one.

The 3 stages of frozen shoulder

The classic description comes from a 1975 study that followed 41 people for 5 to 10 years and found the condition passed through three stages in order (Reeves, 1975).

Stage 1, freezing (the painful stage). The shoulder becomes increasingly painful, often worst at night and with sudden or reaching movements. Movement starts to reduce.

Stage 2, frozen (the stiff stage). The pain often eases but the stiffness takes over. Turning the arm outwards, reaching up and reaching behind your back are usually the most limited.

Stage 3, thawing (the recovery stage). Movement slowly returns, along with the ability to do the things that were impossible a few months earlier.

In practice the stages blur into each other, and a 2017 review found the evidence for fixed, predictable stages is weaker than textbooks suggest (Wong et al., 2017). They are still a useful way to understand where you are and what is likely to help.

How long does frozen shoulder last?

You may have read that it settles in 18 months. In the 1975 study the average was 30 months from start to finish, and those with a longer stiff stage tended to have a longer recovery stage too (Reeves, 1975).

Nor does everyone get back to a completely normal shoulder. In the UK study, an average of 4.4 years after symptoms began, 59% had normal or near normal shoulders and 41% still had some symptoms. Most of those were mild, and only 6% had severe pain and loss of function (Hand et al., 2008). The 2017 review found that without treatment, movement improved but not completely over 1 to 4 years, with most of the improvement coming early rather than late (Wong et al., 2017).

The NHS describes recovery as taking months or years, with pain and stiffness usually going eventually (NHS, 2024). That matches what we see. The good news is that you don't have to sit and wait it out.

What helps frozen shoulder?

A steroid injection, early, with home exercise

The largest analysis to date pooled 65 trials and 4,097 people. A steroid injection into the shoulder joint was the only treatment that was clearly better in the short term, up to 12 weeks, for pain and function. Adding home exercise and physiotherapy may add benefit in the medium term. The authors recommend an early injection with a home exercise programme for frozen shoulder that has been present for less than a year (Challoumas et al., 2020).

In our experience the injection is most useful in the painful first stage, when night pain is wrecking sleep and exercise is too sore to do properly. We don't expect it to shorten the stiff stage on its own.

We offer injections at The Treatment Table, and they can be given with ultrasound guidance. The 2025 British Elbow and Shoulder Society guideline found no clear difference in outcome between guided and unguided injections for frozen shoulder specifically (Rupani and Gwilym, 2025), so the benefit of guidance is mainly accuracy and confidence in where the injection goes rather than a better result.

Physiotherapy and home exercise

In the UK FROST trial, 503 adults across 35 UK hospitals were given one of three treatments: early structured physiotherapy with a steroid injection, manipulation under anaesthetic, or keyhole surgery to release the capsule. The physiotherapy group had up to 12 sessions over 12 weeks, combining hands on mobilisation with a progressive home exercise programme (Rangan et al., 2020).

At 12 months, average shoulder scores out of 48 were 40.3 after surgery, 38.3 after manipulation and 37.2 after physiotherapy with an injection. None of the differences were large enough to matter clinically, and the surgery group had more serious complications (Rangan et al., 2020). Physiotherapy with an injection was also the cheapest of the three (Corbacho et al., 2021).

It is fair to say the research can't yet show how much supervised physiotherapy adds on its own compared with time, and the 2025 BESS guideline said as much (Rupani and Gwilym, 2025).

The kind of exercise changes with the stage. In the painful stage we keep it gentle and within comfort, aiming to keep what movement you have without stirring up the pain. Once the pain settles, the focus shifts to stretching into the stiffness and getting strength back through the range you regain.

Hydrodilatation

Hydrodilatation involves injecting a larger volume of fluid into the joint to stretch the capsule. The evidence is mixed. One 2023 review found it gave a short lived extra improvement over a steroid injection alone (Poku et al., 2023), while a 2018 meta-analysis concluded the effect was small and not clinically meaningful (Saltychev et al., 2018).

Things you can do at home

The NHS advises keeping the shoulder moving gently and avoiding the movements that cause the most pain, using simple painkillers, and trying a heat pack for up to 20 minutes at a time (NHS, 2024).

Surgery for frozen shoulder

Manipulation under anaesthetic and keyhole capsular release are options for people who aren't improving. Given the UK FROST results above, most people are better off giving the non surgical route a proper try first.

Is it frozen shoulder or something else?

The most common thing frozen shoulder gets confused with is a rotator cuff problem. One clue we use in clinic is that frozen shoulder limits movement whether you move the arm yourself or someone moves it for you, especially turning the arm outwards with the elbow by your side. With most rotator cuff problems, someone else can usually move the arm further than you can. The two are treated quite differently, which is why getting the diagnosis right comes first.

See your GP or get assessed promptly if your shoulder pain followed a fall or injury and you can't lift the arm, if you feel unwell or feverish with it, or if the shoulder is hot, red and swollen.