“Frozen Shoulder” — When Your Joint Turns to Ice

As Halloween approaches and the chill starts to creep in, let’s talk about another kind of freezing — one that happens inside your shoulder. Frozen shoulder, also known as adhesive capsulitis, is a condition where the shoulder becomes painful and gradually loses its range of motion. According to a 2022 review by Millar and colleagues in Nature Reviews Disease Primers, it affects about 2–5% of adults, most commonly between the ages of 40 and 60. Women are slightly more likely to develop it and people with diabetes or thyroid disorders are at higher risk. It can also appear after an injury or period when the shoulder isn’t being moved much — for example, following surgery or wearing a sling.

Inside the joint, the problem starts with inflammation of the capsule — the soft tissue that surrounds the shoulder. Over time, this tissue thickens and tightens, forming scar-like bands that limit movement. The process involves special cells called fibroblasts turning into myofibroblasts which contract and make the capsule even stiffer. Nerves and small blood vessels also grow into the area, contributing to pain and sensitivity. In simple terms, the shoulder’s “soft jacket” becomes too tight, restricting motion and causing discomfort.

Frozen shoulder usually unfolds in three phases. The first, known as the “freezing” phase, is marked by gradually increasing pain, often worse at night, along with a slow loss of movement. The second, or “frozen” phase, is when stiffness dominates — the pain may ease slightly, but reaching overhead, behind your back, or even getting dressed can be tough. Finally comes the “thawing” phase, when the shoulder slowly regains motion. The entire process can take many months or even a few years, though most people do improve over time.

Diagnosis is based mostly on a physical exam. Your healthcare provider checks both your active motion (how far you can move your arm yourself) and passive motion (how far it can be moved for you). Imaging like X-rays or MRI isn’t used to confirm frozen shoulder but to rule out other issues like arthritis or a rotator cuff tear.

Treatment focuses on managing pain and maintaining movement while the shoulder goes through its natural recovery process. Gentle stretching and physical therapy are key to preventing further stiffness. Anti-inflammatory medications or corticosteroid injections may help in the early stages, and a procedure called hydrodilatation — where fluid is injected into the joint to stretch it — can offer some relief. In more severe or stubborn cases, options such as manipulation under anesthesia or arthroscopic capsular release (a minimally invasive surgery to loosen the capsule) may be considered.

Although frozen shoulder can be frustratingly slow to heal, the good news is that most people eventually regain functional motion. Think of it as your shoulder getting “stuck in the ice” — with the right care, time and gentle movement, it will thaw. This Halloween, as you look at the snow-covered skeleton in the image above, remember that while creaky joints can feel spooky, they often just need warmth, patience and mindful motion to come back to life.

Lauren DeYoe

Doctor of Physical Therapy

Reiki Master

Owner Reiki PT