Adhesive Capsulitis (Frozen Shoulder): Symptoms, Treatment & UK Online Doctor Guide

Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterised by spontaneous pain and a progressive loss of both active and passive range of movement in the shoulder joint. It occurs when the flexible tissue surrounding the shoulder joint (the capsule) becomes thickened, inflamed, and tight.

According to NHS data, the condition most commonly affects people between the ages of 40 and 60 and is more prevalent in women. It is also more frequent in individuals with certain underlying health conditions, such as diabetes or thyroid disorders. While the exact cause isn't always clear, it often follows a period of immobility, such as recovery from surgery or a stroke.

Frozen shoulder typically follows a predictable clinical path, frequently divided into three stages as per NICE (National Institute for Health and Care Excellence) clinical knowledge summaries:

• The 'Freezing' Stage (2 to 9 months): This is the most painful phase. The pain is often worse at night or when lying on the affected side. You will notice a gradual loss of movement.
• The 'Frozen' Stage (4 to 12 months): Pain may actually start to improve, but the stiffness becomes profound. Daily tasks like reaching for a seatbelt or washing your hair become very difficult.
• The 'Thawing' Stage (6 months to 2 years): The shoulder gradually begins to loosen, and the range of movement slowly returns to normal or near-normal.

Understanding which stage you are in is vital because it determines the most appropriate treatment strategy.

The primary goal of managing adhesive capsulitis is to control pain and prevent further stiffness. In the UK, GPs follow evidence-based pathways to ensure patients receive the right care at the right time.

Pain Relief

Over-the-counter medications such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are often the first line of defence. If these are insufficient, a GP may prescribe stronger analgesics.

Physiotherapy

Physiotherapy is a cornerstone of recovery. During the freezing stage, the focus is on gentle stretching. As you move into the thawing stage, more intensive exercises are introduced to regain muscle strength and flexibility. Consistency with a home exercise plan is essential for a good outcome.

Steroid Injections

If pain is severe and unmanageable, a corticosteroid injection into the shoulder joint may be considered. These are most effective if administered early in the freezing stage to reduce inflammation, though they are usually a temporary measure to facilitate physiotherapy.

If you are experiencing persistent shoulder pain that is interfering with your sleep or daily activities, you should seek medical advice. Speaking to an online doctor in the UK can be a convenient first step for an initial assessment.

During a video consultation, a GP can discuss your medical history, observe your range of movement through guided tests, and help differentiate frozen shoulder from other conditions like rotator cuff tears or osteoarthritis. An online GP can provide:

• Clinical diagnosis and advice on self-management.
• Prescriptions for stronger pain relief if appropriate.
• Referrals to private physiotherapy services.
• A formal sick note if your shoulder mobility prevents you from performing your job safely.

A private GP service ensures you can get an appointment quickly, helping you start management before the stiffness becomes debilitating.

While you wait for the condition to resolve, minor changes to your routine can help. Try to keep the shoulder moving within its limits to prevent the muscles from wasting (atrophy). Applying a heat pack to the shoulder for 15-20 minutes before performing gentle stretches can make the exercises more comfortable. If night pain is an issue, try supporting the affected arm with a pillow while sleeping on your back.