About frozen shoulder (adhesive capsulitis)
The shoulder joint is surrounded by a flexible capsule. In frozen shoulder, this capsule becomes inflamed, then thickens and tightens, so the arm cannot move fully in any direction, even when someone else tries to move it for you.
Frozen shoulder tends to move through phases. First comes a painful stage, then a stiff stage where pain may ease but motion stays limited, and finally a gradual thawing. This process can take a long time, and treatment aims to ease pain and bring back motion sooner.
Common symptoms
- Shoulder pain that builds gradually, often without a clear injury
- Stiffness in every direction, especially turning the arm outward
- Night pain that disrupts sleep
- Trouble reaching overhead, behind your back, or fastening clothing
- Sharp pain with sudden or unexpected arm movements
Common causes and risk factors
- Diabetes, which raises risk significantly
- Thyroid conditions
- A period of shoulder immobility after injury or surgery
- Middle age, with women affected more often
How we diagnose it
Our physicians compare how far you can move your arm with how far it can be moved for you. In frozen shoulder, both are limited. Ultrasound at the exam table checks the capsule and rotator cuff and helps rule out tears or calcium deposits, and an X-ray helps rule out arthritis, which can look similar.
How Propel treats frozen shoulder (adhesive capsulitis)
Early care focuses on calming pain so the shoulder can keep moving. A guided corticosteroid injection into the joint during the painful stage can reduce inflammation. A nerve block, such as a suprascapular nerve block, may also be used to help manage pain in this early phase. A gentle, progressive motion and strengthening plan helps you keep using the arm for daily life and exercise.
For a shoulder that stays stiff, Dr. Gruner and Dr. Chen offer capsular distension, also called hydrodilatation. Under ultrasound, fluid is placed into the joint to gently stretch the tight capsule from the inside, and therapy starts right after to build on the new motion. When stiffness persists despite these steps, we help coordinate referral for other options.
Watch: Frozen Shoulder (Adhesive Capsulitis) explained
More videos
How capsular distension (hydrodilatation) stretches a tight shoulder capsule to help restore motion.Featuring Dr. Gruner The exam findings that separate frozen shoulder from rotator cuff and other causes of shoulder pain.Featuring Dr. Gruner What to expect during capsular distension for frozen shoulder and how therapy builds on it.Featuring Dr. Gruner
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Rehab protocols
Dr. Gruner's week-by-week recovery guidelines. Your plan is individualized; follow these with your physician and physical therapist.
Questions about frozen shoulder (adhesive capsulitis)
- How long does frozen shoulder last?
- Without treatment, frozen shoulder often lasts many months and can stretch past a year. Treatment aims to ease pain and bring back motion sooner, though the timeline varies from person to person.
- What is capsular distension (hydrodilatation) for frozen shoulder?
- Capsular distension, or hydrodilatation, is an ultrasound-guided procedure that fills the shoulder joint with fluid to gently stretch the tight capsule. It is done in the office and paired with a motion program right afterward.
- Does diabetes affect frozen shoulder?
- Yes. People with diabetes are more likely to develop frozen shoulder and may have a slower course. Good blood sugar control and early treatment can help.