What Are the 4 Stages of a Frozen Shoulder?

Progression of a Frozen Shoulder

Frozen shoulder, or adhesive capsulitis, causes stiffness and pain in the shoulder joint. It advances through four stages, each with different symptoms, requiring specific treatments to support recovery. Here’s how it happens:

Pre-Freezing Stage

This is the first stage, where the shoulder starts to feel sore and stiff. The pain is usually mild to moderate, often worse at night or with certain movements. While movement becomes slightly harder, the shoulder can still function.

This stage can last for weeks or months and may be triggered by injury, overuse, or health conditions like diabetes or thyroid problems. Treatment includes physical therapy to keep the shoulder moving, pain relief medications, and avoiding activities that make symptoms worse.

Freezing Stage

In this stage, pain and stiffness get much worse. It can last from 6 weeks to 9 months. The shoulder capsule becomes inflamed and thickened, making movement very difficult. Pain can be severe, especially when trying to move the arm, and may even interfere with sleep. During this phase, treatment focuses on managing pain with medications or injections and doing physical therapy to maintain as much movement as possible.

Frozen Stage

At this stage, the shoulder is extremely stiff, and movement is very limited, but pain may decrease since inflammation has gone down. Simple tasks become very difficult due to restricted mobility. This phase can last 4 to 12 months. Treatment focuses on gentle exercises and physical therapy to prevent further stiffness. In severe cases, surgery may be needed to loosen the joint.

Thawing Stage

The final stage is when the shoulder gradually regains movement and becomes less stiff and painful. This recovery phase can take 6 months to 2 years. As the shoulder heals, rehabilitation exercises help restore strength and flexibility. A structured rehab program is essential to make full recovery possible and prevent the condition from returning.

What Is the Main Cause of a Frozen Shoulder?

The exact cause of a frozen shoulder (adhesive capsulitis) isn’t fully known. However, it happens when inflammation makes the shoulder joint capsule thick and tight. It often develops after the shoulder has been immobile for a long time due to surgery, injury, or other health issues. People with diabetes or thyroid problems are more likely to have this condition.

Do’s and Don’ts of a Frozen Shoulder

Managing a frozen shoulder (adhesive capsulitis) requires knowing what helps and what to avoid. Here are key do’s and don’ts to support recovery:

Do’s:

1. Attending all physical therapy sessions is important for progress and proper guidance.
2. Stick to your prescribed exercises to improve movement and reduce stiffness.
3. Apply ice to your shoulder for about 10 minutes several times a day to reduce pain and swelling.
4. Follow your doctor’s advice on pain relievers or anti-inflammatory drugs to manage discomfort.
5. Gentle movement helps prevent more stiffness.
6. Sit and stand with good posture, and use pillows to support your arm while sleeping to ease discomfort.

Don’ts

1. Don’t force movements that cause sharp pain, as this can make things worse.
2. Avoid keeping your shoulder completely still.
3. Always see a doctor for the right diagnosis and treatment instead of trying to manage it on your own.
4. Start with gentle stretching before adding strengthening exercises to avoid setbacks.
5. Stay away from sports or sudden arm movements that can strain your shoulder and slow healing.

Wrapping Up

A frozen shoulder causes intense pain and restricted movement in the shoulder. It develops in four stages and may take up to two years to heal fully. However, knowing what to expect at each stage will help you manage it with ease.

Visit our sports medicine & shoulder specialist at Barrett S. Brown, MD. Our doctor specializes in arthroscopic and open reconstructive surgery for the shoulder and knee, including shoulder replacements. Call us at (346) 247-2531 to make an appointment.