Frozen shoulder

Frozen shoulder means your shoulder becomes painful and stiff for months, sometimes years. The two main symptoms are pain, which can be worse at night and disturb sleep, and stiffness that makes the shoulder difficult to move (NHS). The tissue around the joint becomes inflamed, then tightens and shrinks (NHS). Its medical name is adhesive capsulitis, after the fibrous changes in the joint capsule that make the shoulder gradually lose movement (Li et al., 2025).

Who gets frozen shoulder?

It mostly affects middle-aged adults (Li et al., 2025). Around 10% of people in their fifties are affected, and it is slightly more common in women (Brealey et al., 2020).

• Diabetes is the strongest known link. A meta-analysis of 18 studies found that people with diabetes were five times more likely than others to have frozen shoulder, which affected about 13% of them. Going the other way, about 30% of people with frozen shoulder had diabetes (Zreik et al., 2016).
• Thyroid problems are another endocrine condition linked with it (Li et al., 2025).
• A period of not moving the arm, after an injury or surgery, can set it off (NHS).

Often, though, it is not clear why someone gets it (NHS).

Is frozen shoulder caused by desk work?

Desk work isn’t among the recognised causes above. Shoulder pain in people who use a computer all day is usually something else. The NHS lists pain that is worse while using the arm as more typical of tendonitis, bursitis or impingement, and pain and stiffness that don’t go away over months or years as more typical of frozen shoulder or arthritis (NHS). The more common desk-related problems, including those of the rotator cuff, are covered in shoulder pain from computer work.

What sets frozen shoulder apart is that the joint is stiff even when someone else moves it. The UK FROST trial, for example, required the affected shoulder to turn outwards less than half as far as the other one when moved by an examiner, with an X-ray ruling out other causes (Brealey et al., 2020).

Does frozen shoulder get better on its own?

The NHS says it can take months or years, but the pain and stiffness usually go away eventually (NHS). The old textbook story is more confident: three phases, painful, stiff and recovering, ending in full recovery without treatment. A 2017 systematic review found no evidence for that sequence. Untreated shoulders improved, but not completely, over one to four years, and most of the improvement came early rather than late. Much of the evidence was of low quality (Wong et al., 2017).

What do the treatment trials show?

The NHS approach works in steps: pain relief, sometimes stronger painkillers or a steroid injection, then gentle movement and physiotherapy lasting at least six weeks. It also advises keeping the shoulder moving, as keeping it still makes the pain worse, and not making up your own strenuous exercises (NHS).

• Manual therapy and exercise. A Cochrane review of 32 trials with 1,836 people found that six weeks of hands-on treatment, such as joint mobilisation, combined with exercise probably helped less than a steroid injection at seven weeks: 46% versus 77% reported treatment success in one trial. By six and 12 months, the differences were not clinically important (Page et al., 2014).
• Surgery. The UK FROST trial randomised 503 adults in 35 hospitals to early structured physiotherapy with a steroid injection, manipulation under anaesthetic, or keyhole surgery to release the capsule. At 12 months the differences in shoulder scores were small and not clinically important. Serious adverse events were rare, and mostly happened in the surgical groups (Brealey et al., 2020).

If you are weighing up private treatment, How much does physiotherapy cost? sets out the options.

When to see a doctor

See a GP if shoulder pain and stiffness don’t go away, or the pain makes it hard to move your arm (NHS). Ask for an urgent GP appointment or contact NHS 111 if you have sudden or very bad shoulder pain, can’t move your arm, have pins and needles that don’t go away or no feeling in the arm, the pain started after a fall or injury, or you feel feverish or unwell (NHS).