Private frozen shoulder clinic in London, same-day physiotherapy.

The three phases

Total duration is commonly one to three years. Most people recover full or near-full movement. Knowing which phase you are in matters, because aggressive stretching during the painful freezing phase makes things worse, while the same exercises during the frozen phase are exactly right.

The signs

• pain deep in the shoulder, often radiating to the upper arm, that is severe at night and makes lying on that side impossible
• progressive loss of movement, particularly reaching behind your back and rotating outwards
• difficulty with bras, seatbelts, hair, coats and reaching into a back pocket
• movement is restricted whether you move it or someone else does — the joint itself will not go further

Treatment by phase

• Freezing phase — control the pain. Regular analgesia, anti-inflammatories if suitable, and sleeping propped with a pillow supporting the arm. Gentle movement within a comfortable range only. Do not force it.
• A corticosteroid injection into the joint is most effective early, during the painful phase. It reduces pain substantially and appears to shorten the overall course. This is the intervention most often left too late.
• Frozen phase — work on range. This is where physiotherapy earns its place, with stretching into the restricted directions, held and repeated daily.
• Hydrodilatation — injecting fluid to stretch the capsule under imaging — can improve movement where stiffness persists.
• Surgery or manipulation under anaesthetic for the minority who remain significantly restricted after a year or more of proper treatment.

Living with it