What it is
Adhesive capsulitis is a condition characterised by painful stiffness of the shoulder capsule. The capsule becomes thick and tight, which restricts movement in all directions. It follows a recognised pattern of freezing, frozen, and thawing phases.
The condition often resolves over time. The focus is on pain control and function while the range of motion returns.
What happens when it occurs
The capsule inflames and contracts. Movements that stretch the capsule cause sharp pain. A steady programme preserves function while pain and stiffness ease.
Common causes and risk factors
- More common in women than in men
- Higher prevalence of diabetes and thyroid conditions
- History of shoulder or breast surgery
- Immobilisation after injury
Who is most affected
Adults between forty and sixty. People with diabetes are overrepresented in clinics.
Typical symptoms
- Global stiffness with sharp end range pain
- Trouble reaching overhead and behind the back
- Night pain and disturbed sleep
When to seek care
If pain and stiffness limit dressing, work, or sleep.
How we diagnose
The clinical examination reveals loss of both active and passive range of motion. Imaging is used to rule out other causes or to guide injections.
Management
- Pain control with pacing, heat or ice, and simple analgesics
- Gentle range of motion within tolerance
- Scapular and rotator cuff strength without forcing range
- Hydrodilatation or corticosteroid injection in selected cases
- Manipulation or capsule release for severe persistent cases
Rehabilitation milestones
Freezing phase: pain control, gentle range of motion, and maintaining function.
Frozen phase: progress range gradually, build strength in safe arcs.
Thawing phase: widen range and restore overhead use and confidence.
Readiness to progress
- Night pain reduces
- Range increases steadily
- Daily tasks become easier
Long-term care
- Keep the shoulder moving in comfortable arcs
- Maintain strength as range returns
- Manage metabolic health and sleep
Australia snapshot
- Common in primary care and physiotherapy settings
- Women present more often than men
- Access to hydrodilatation and image-guided injections is widespread
Latest insights
The capsule thaws on its own timeline. You control the quality of that journey with pacing and strength.
Forcing range backfires. Calm, frequent movement wins.
