It often starts quietly: a dull ache in the shoulder, then a growing struggle to reach behind your back, put on a coat or fasten a bra. Before long, the shoulder feels stuck, and the pain can wake you at night. This is how many people describe frozen shoulder, and it is one of the shoulder problems we see regularly at our physiotherapy clinic in Swords.
Written by Elena Terrón, Chartered Physiotherapist (CORU Reg. PT044701, ISCP MISCP17788)
What Is Frozen Shoulder?
Frozen shoulder, also called adhesive capsulitis, happens when the capsule of tissue around the shoulder joint becomes inflamed, thickened and tight. As a result, the shoulder becomes painful and gradually loses movement, both when you try to move it yourself and when someone else moves it for you.
It is most common between the ages of 40 and 60 and affects women more often than men. It is also more likely in people with diabetes or thyroid problems, and it can appear after a period of keeping the arm still, for example after an injury or surgery. Often, though, there is no clear cause.
The Three Stages of Frozen Shoulder
Frozen shoulder usually moves through three overlapping stages. Knowing which one you are in helps to choose the right treatment:
- Freezing (painful) stage: pain builds up, often worse at night and when lying on the affected side, and movement starts to reduce. This can last from a few weeks to several months.
- Frozen (stiff) stage: the pain often eases, but the shoulder becomes very stiff. Everyday tasks like reaching up to a shelf or behind your back become difficult.
- Thawing stage: movement gradually returns. This can be slow, and it is where a structured exercise plan makes a real difference.
Every person is different, but the whole process can take from several months to a couple of years. The good news is that most people recover a large part of their movement, and physiotherapy can help you stay as comfortable and active as possible along the way.
Is It Frozen Shoulder or Something Else?
Not every stiff or painful shoulder is a frozen shoulder. Rotator cuff problems, bursitis, arthritis or pain coming from the neck can feel similar but need a different approach. Typical signs that point towards frozen shoulder include:
- Stiffness in all directions, especially when turning the arm outwards or reaching behind your back
- Pain at night that makes it hard to sleep on that side
- Difficulty with dressing, washing your hair or reaching into the back seat of the car
- A gradual start, with no big injury to explain it
A thorough assessment helps to confirm what is going on, so your treatment matches the real cause of your pain.
When to Seek Medical Help Quickly
Contact your GP or seek urgent care if shoulder pain comes with any of the following:
- Pain in the chest, jaw or left arm, shortness of breath or feeling unwell (call 112 or 999)
- A fall or injury after which you cannot lift your arm
- A hot, red or swollen joint, or fever
- Unexplained weight loss, or pain that keeps getting worse despite rest
How Physiotherapy Can Help With Frozen Shoulder
At Axios Physio, treatment always starts with a detailed assessment of your shoulder, neck and posture, and a conversation about what you need to get back to, whether that is work, sleep, sport or lifting your children. Depending on your stage, your plan may include:
- Pain relief and advice in the painful stage, including positions for sleeping and ways to keep using the arm without flaring it up
- Hands-on treatment to ease tension and help the joint move more freely
- Gentle, progressive exercises to recover range of movement and strength, adapted as your shoulder changes
- INDIBA® therapy as part of the session, which some patients find helpful for comfort and mobility. Learn more about INDIBA®
- A clear home plan, so the progress you make in the clinic continues between sessions
If needed, we will also let you know when it is worth talking to your GP about other options, such as a steroid injection, which can be combined with physiotherapy.
What You Can Do at Home
- Keep the arm moving gently within a comfortable range rather than resting it completely
- Use heat (a warm shower or a heat pack) before your exercises to help the shoulder relax
- Support the arm with a pillow at night to make sleeping more comfortable
- Avoid forcing painful stretches, especially in the early stage: more pain does not mean faster progress
- Be patient and consistent: little and often works better than one big effort
How Long Does Frozen Shoulder Take to Get Better?
Frozen shoulder takes time, and it is normal to feel frustrated. Many people notice that pain and sleep improve within the first weeks of the right treatment, while movement returns more gradually. After your first assessment, we will explain what to expect in your case and how we will measure your progress.
Shoulder pain is only one of the problems we help with. You can see the full list on our conditions we treat page, or read our guide on sciatica and low back pain.
Good to know: physiotherapy with a chartered physiotherapist may qualify for tax relief in Ireland. We explain how in our guide on claiming tax relief on your physiotherapy sessions.
Book a Shoulder Assessment in Swords
If a stiff or painful shoulder is affecting your sleep, work or daily life, you don’t have to wait for it to sort itself out. Book an assessment at Axios Physio on Main Street, Swords, just a short trip from Malahide, Donabate and Dublin Airport, or message us on WhatsApp if you have any questions first.
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