Frozen shoulder is a condition in which the capsule of the shoulder joint becomes inflamed, thickens and tightens, causing pain and progressive stiffness of the shoulder in all directions. It affects about 2–5% of adults, most often people between 40 and 60 years of age, and is more common in women and people with diabetes. It progresses through three stages: painful, stiff and thawing.
Below we describe how to tell frozen shoulder apart from other kinds of shoulder pain, what happens at each stage, when you need a doctor and what rehabilitation involves.
In brief
- Frozen shoulder affects about 2–5% of adults and is several times more common in people with diabetes.
- The condition has 3 stages; in most people movement gradually returns, but some are left with a slight restriction.
- Exercises and rehabilitation are matched to the stage – in the painful phase, forceful stretching usually does harm.
- A physiotherapy consultation in Rydułtowy costs PLN 180, manual therapy PLN 180.
- The clinic is open Mon–Fri 7:00–20:00, private visits only (not covered by NFZ, the Polish public health fund).
Contents
What are the symptoms of frozen shoulder?
Typical symptoms are shoulder pain spreading into the upper arm, worse at night and when lying on the affected side, and a gradually increasing restriction of movement. The earliest difficulty is turning the arm outwards and reaching behind your back, e.g. fastening a bra or reaching into a back pocket. Movement is restricted even when another person lifts the arm.
This last point distinguishes frozen shoulder from rotator cuff tendon pain, in which the shoulder hurts in part of the range but can be raised with help. We describe that second problem in our article shoulder pain when raising your arm – what to do. Frozen shoulder can appear for no obvious reason or after an injury, surgery or a period of immobilisation of the arm.
What are the stages of frozen shoulder?
Three stages are distinguished: freezing, in which pain dominates; frozen, in which the pain eases but the shoulder is at its stiffest; and thawing, when movement gradually returns. The boundaries between them are fluid, and the duration of each stage varies greatly – in the literature the whole course is usually described as lasting from several months to 2–3 years.
| Stage | What dominates | What physiotherapy focuses on |
|---|---|---|
| Freezing | pain, also at night; increasing restriction of movement | reducing pain, gentle movement without forcing, sleeping positions |
| Frozen | stiffness, less pain | gradually increasing the range, mobilisations, home exercises |
| Thawing | return of movement | rebuilding range and strength, returning to work and sport |
The pace of moving through the stages is individual and cannot be predicted in advance.
When should you see a doctor first with shoulder pain and stiffness?
It is worth having a diagnosis of frozen shoulder confirmed by a doctor, because similar symptoms can be caused by, among other things, joint degeneration, calcifications, a previous dislocation or tumours. The doctor usually orders an X-ray, and sometimes an ultrasound. See a doctor urgently if you have a fever, an injury with a deformed shoulder, pain with shortness of breath or night pain with unintended weight loss.
Red-flag symptoms: fever and redness of the shoulder, an injury or fall before the stiffness began, sudden pain with pressure in the chest (call 112), weight loss, a history of cancer, weakness or numbness of the whole arm. You will find recommended doctors on the Recommended specialists page.
What does rehabilitation for frozen shoulder involve?
Rehabilitation involves matching movement to the stage of the condition: in the painful phase, gentle exercises and pain-relieving methods are used, and in the stiff phase – joint mobilisations, manual therapy and gradual stretching. The physiotherapist also teaches home exercises. A doctor may additionally suggest a steroid injection, which makes exercise easier during periods of severe pain.
If the condition does not respond, a doctor may consider hydrodilatation or surgery. The physiotherapist sets the pace and intensity of therapy after the consultation and decides on the number of visits individually.
Physiotherapy consultationassessment of range of movement, identifying the stage and an exercise plan180 PLN Manual therapymobilisations of the shoulder joint and shoulder blade in the stiff phase180 PLNPrices valid from 08.2026.
Which exercises can you do at home?
At home you can safely do gentle mobility exercises that do not cause pain stronger than 3–4 on a 0–10 scale and do not make it worse the next day. The 3 exercises below are general. In the painful phase, do them in a smaller range, and in the stiff phase you can hold the end position a little longer.
- Pendulum. Lean on a table with your good arm, let the affected arm hang loosely and make small circles by swaying your body. 10 circles in each direction, 2–3 times a day.
- Table slide. Sitting down, slide your hand forward on a towel while leaning your body forward. 10 repetitions, hold for 5 seconds, twice a day.
- Rotation with a stick. Lying on your back, with your elbow by your side bent at a right angle, hold a stick in both hands and use your good arm to gently push the affected arm outwards. 10 repetitions, 2 sets, once a day.
If the pain gets worse or spreads, stop the exercise and consult a physiotherapist.
Good to know: in people with diabetes, frozen shoulder is more common and tends to be more persistent, so it is worth telling your physiotherapist if you have diabetes.
You can read more about other joint problems in our guide joint pain and injuries.
Summary
Frozen shoulder is a tightening of the joint capsule that goes through 3 stages: pain, stiffness and thawing. Rehabilitation is matched to the stage, and it is worth having the diagnosis confirmed by a doctor. A consultation in Rydułtowy costs PLN 180.
Frequently asked questions
How long does frozen shoulder last?
The duration of frozen shoulder varies greatly. In scientific publications the whole course is usually described as lasting from several months to 2–3 years, and some people are left with a slight restriction of movement. Rehabilitation does not shorten the condition in a predictable way, but it helps to control pain and maintain function.
Does frozen shoulder go away on its own?
In many people the symptoms ease on their own over time and movement gradually returns. However, some patients have a long-lasting restriction of movement or pain that makes work and sleep difficult. That is why it is worth consulting a doctor and a physiotherapist rather than waiting for the shoulder to “thaw” by itself, especially during the painful phase.
Why does frozen shoulder hurt at night?
Night pain is linked to inflammation of the joint capsule and pressure on the shoulder when lying on the affected side. Sleeping on your back with a pillow under your forearm, or on your good side with a pillow against your chest, may help. Decide on painkillers for the night together with a doctor or pharmacist.
Is diabetes linked to frozen shoulder?
Yes, diabetes is one of the best-known risk factors for frozen shoulder. In people with diabetes the condition is more common, more often affects both shoulders and tends to be more persistent. A link has also been described with thyroid disease. Good blood sugar control is important for joint health too.
Can frozen shoulder occur in the other shoulder?
Yes, in some people frozen shoulder later develops in the other shoulder, usually not at the same time. Getting it again in the same shoulder is rare. If you notice the first symptoms on the other side, e.g. difficulty reaching behind your back, it is worth booking a consultation early.
Do I need a referral for shoulder rehabilitation, and is it covered by the NFZ?
The “W zdrowym ciele” clinic in Rydułtowy offers private visits only and has no contract with the NFZ. A referral is usually not required for a private visit, and a consultation costs PLN 180. It is worth bringing your shoulder X-ray or ultrasound results and information about your medicines and injections.
Sources
- Kelley M.J. et al., Shoulder pain and mobility deficits: adhesive capsulitis. Clinical practice guidelines, JOSPT, 2013.
- Rangan A. et al., Frozen shoulder (BESS/BOA Patient Care Pathway), Shoulder & Elbow, 2015.
- Zreik N.H. et al., Adhesive capsulitis of the shoulder and diabetes: a meta-analysis, Muscles, Ligaments and Tendons Journal, 2016.
About the author: Tatiana Grabowska, MSc – master’s degree in physiotherapy, licence to practise number PWZFz 11646 (Polish physiotherapist licence). Since 2013 she has run the “W zdrowym ciele” physiotherapy and rehabilitation clinic in Rydułtowy; she has about 12 years of professional experience. Physiotherapist’s profile
- Consultation180 PLN
- Referralnot needed
- ReceptionMon–Fri: 7.00–20.00
