Frozen Shoulder: What It Is and How to Treat It Without Surgery
Understanding Adhesive Capsulitis
Frozen shoulder — also called adhesive capsulitis — is a condition in which the capsule of connective tissue surrounding your shoulder joint becomes inflamed and progressively tightens. The result is a significant loss of both active and passive range of motion, accompanied by pain that can interfere with sleep and basic daily tasks.
The condition tends to develop in three overlapping phases. During the freezing phase, pain gradually intensifies and shoulder movement becomes increasingly limited. In the frozen phase, pain may diminish somewhat, but stiffness remains severe. The thawing phase brings a slow return of motion, though the full recovery process can take one to three years without treatment.
Frozen shoulder is more common in people between the ages of 40 and 60, in women, and in individuals with diabetes, thyroid conditions, or a history of shoulder immobilization after another injury. Understanding what drives the condition is the first step toward choosing the right treatment.
Non-Surgical Treatment Options
The large majority of frozen shoulder cases resolve without surgery, provided patients engage in consistent treatment. The goal of non-surgical care is to control pain and restore range of motion progressively.
Physical therapy is the cornerstone of treatment. A therapist guides you through stretching exercises targeting the glenohumeral joint capsule. Passive stretching — where the therapist moves your shoulder through its range rather than relying on your own muscle effort — is particularly valuable in the early stages when active movement is painful. Techniques such as joint mobilization can accelerate progress.
Corticosteroid injections into the shoulder joint reduce inflammation and can meaningfully decrease pain, especially during the freezing phase. When injections are combined with physical therapy, outcomes tend to be better than with either treatment alone. Relief typically sets in within one to two weeks and may last several months.
NSAIDs (nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen) help manage baseline pain and make participation in physical therapy more tolerable. They are most useful early in the course of the condition and should be taken under physician guidance, particularly if you have kidney, stomach, or cardiovascular concerns.
Hydrodilatation, also called distension arthrography, is a procedure in which sterile fluid is injected into the shoulder joint under imaging guidance to stretch the contracted capsule. It can offer rapid improvement in range of motion and is typically considered when physical therapy alone has produced insufficient progress.
Manipulation under anesthesia (MUA) involves a physician gently moving your shoulder through its full range while you are sedated. This breaks up capsular adhesions and scar tissue. The procedure is brief and is followed immediately by physical therapy to maintain the gains achieved.
What to Expect From Recovery
Non-surgical treatment requires patience. Most patients see meaningful improvement within three to six months of consistent physical therapy, though the timeline varies based on the severity of the condition and any underlying medical factors. Regular participation in your home exercise program — not just clinic visits — is essential to progress.
If you have diabetes, blood sugar control during this period is especially important; poorly controlled glucose levels are associated with a more prolonged and resistant course of frozen shoulder.
When to Seek Evaluation
Do not wait for the pain to become severe before consulting a specialist. Early diagnosis allows treatment to begin in the freezing phase, when the condition is most responsive to intervention. If you have noticed increasing shoulder pain and stiffness over the past few weeks or months, a prompt orthopedic evaluation can clarify the diagnosis and rule out other causes — such as rotator cuff tears or calcific tendinitis — that can present similarly.
If you're experiencing shoulder stiffness and pain, the specialists at Maryland Orthopedic Specialists can help. Call (301) 515-0900 or [schedule an appointment online](https://www.mdorthospecialists.com/contact).
