Conditions

Frozen Shoulder

Frozen Shoulder

Frozen shoulder, sometimes called adhesive capsulitis, is a condition where the shoulder gradually becomes stiff, painful, and difficult to move. Everyday tasks can become surprisingly challenging, from reaching overhead and putting on a coat to fastening a seatbelt. Many people also notice their sleep is affected, especially when lying on the painful side or turning in bed.
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Understanding Frozen Shoulder

Frozen shoulder occurs when the connective tissue surrounding the shoulder joint (the joint capsule) becomes thickened and tight. This leads to gradual stiffness, pain, and reduced movement. The exact cause is often unclear, but it is believed to result from inflammation and scarring within the capsule.
Symptoms to Watch For

Frozen shoulder most commonly affects people aged 40-60 and is slightly more common in women than men. It can also be associated with medical conditions such as diabetes, thyroid disorders, heart disease, and periods of immobilisation following injury, surgery, or fracture. Sometimes it develops without any clear trigger.

Symptoms to Watch For

 The main features of frozen shoulder include:

  • Gradual onset of shoulder pain, often worse at night or when lying on the affected side
  • Increasing stiffness and difficulty moving the shoulder in all directions
  • Challenges with daily activities such as reaching overhead, dressing, fastening a seatbelt, or combing hair
Stages of Frozen Shoulder
Frozen shoulder usually progresses through three stages:
  • Freezing stage (Painful stage): Gradual onset of pain, particularly at night, with slowly decreasing range of motion. This stage can last 6-9 months. 
  • Frozen stage (Stiff stage): Pain may reduce, but stiffness and limited movement persist, making daily activities difficult. This stage typically lasts 4-12 months.
  • Thawing stage (Recovery stage): Gradual return of movement, which can take 6 months to 2 years. Most people regain functional use of the shoulder, though some may have residual stiffness.
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Assessment at The London Ultrasound Clinic

At The London Ultrasound Clinic, we provide a clear and supportive pathway for people living with a frozen shoulder. Your appointment begins with a hands-on assessment and a detailed ultrasound scan to confirm the diagnosis and rule out other causes of pain, such as rotator cuff problems or arthritis.

Frozen shoulders often improve naturally over time, but this can take months. In the early stages, we usually recommend conservative approaches including reassurance and education about the condition, physiotherapy and guided exercises to maintain gentle mobility, activity modification to reduce discomfort, and pain relief or anti-inflammatory medication if needed. For many patients, these measures can help manage symptoms and support gradual recovery.

When pain and stiffness are more significant, or progress with conservative management is slow, ultrasound-guided injections can help. Using steroid and local anaesthetic, injections reduce inflammation and provide immediate pain relief, making it easier to perform exercises and maintain mobility.
For patients with persistent stiffness despite physiotherapy or standard injections, ultrasound-guided hydrodilatation may be recommended. This procedure gently stretches the tight joint capsule by injecting a mixture of saline, steroid, and local anaesthetic under ultrasound guidance. Hydrodilatation is particularly helpful for those in the freezing or frozen phases of frozen shoulder, as it can accelerate improvement in movement and reduce night-time pain.
After any injection or hydrodilatation, guided exercises and gradual activity progression are essential. Our clinicians provide clear instructions on safe movement, strengthening, and functional exercises to help you regain range of motion and return to daily life confidently. Our aim is to reduce your pain, improve shoulder function, and help you get back to restful sleep, work, and everyday activities with confidence and comfort.

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