By the Four Oaks Physio Clinical Team · May 2026 · 8-minute read

If you’ve woken up unable to lift your arm, struggled to reach behind your back, or found that shoulder pain is disrupting your sleep night after night, you may be dealing with frozen shoulder — one of the most painful and misunderstood musculoskeletal conditions we treat at Four Oaks Physio.

The good news? With the right physiotherapy at the right time, most people make a full recovery.

What Is Frozen Shoulder?

Frozen shoulder — medically known as adhesive capsulitis — is a condition where the capsule of connective tissue surrounding the shoulder joint becomes inflamed, thickened, and scarred. Over time, this causes the capsule to tighten, severely restricting movement and causing significant pain.

It affects around 1 in 20 people in the UK at some point in their lives, most commonly between the ages of 40 and 60, and is slightly more common in women than men. People with diabetes are at significantly higher risk — studies suggest that up to 20% of people with diabetes will develop frozen shoulder at some stage (Diabetes UK).

The Three Stages of Frozen Shoulder

Understanding which stage you are in is critical to receiving the right treatment. Frozen shoulder typically progresses through three distinct phases:

Stage 1 — The Freezing Stage (2–9 months)

This is the most painful phase. The shoulder gradually becomes more and more painful, particularly at night and at the outer ranges of movement. Many patients describe a deep, aching pain that is difficult to locate precisely.

Stage 2 — The Frozen Stage (4–12 months)

The pain may begin to ease slightly, but stiffness reaches its peak. Everyday tasks — reaching overhead, fastening a seatbelt, or getting dressed — become extremely challenging. This is the stage where many patients seek professional help.

Stage 3 — The Thawing Stage (6–24 months)

Movement gradually returns as the capsule loosens. Without treatment, this process can take up to two years or more. With targeted physiotherapy, the thawing stage can be significantly accelerated.

What Causes Frozen Shoulder?

In many cases, frozen shoulder develops without a clear cause — this is known as primary frozen shoulder. However, it can also be triggered by:

A shoulder injury or surgery (secondary frozen shoulder)
Prolonged immobility — for example, after wearing a sling
Underlying health conditions such as diabetes, thyroid disorders, or cardiovascular disease
Rotator cuff injuries that have not been properly rehabilitated

According to the Chartered Society of Physiotherapy (CSP), early intervention with physiotherapy is strongly recommended to prevent the condition progressing and to shorten recovery time.

How Is Frozen Shoulder Diagnosed?

Frozen shoulder is primarily a clinical diagnosis — meaning it is identified through a detailed assessment of your symptoms, history, and a physical examination of shoulder movement, rather than relying solely on imaging.

At Four Oaks Physio, our initial assessment involves:

A thorough history of your symptoms and how they have progressed
Active and passive range of movement testing
Strength and neurological screening to rule out other causes
Assessment of the neck and surrounding structures

In some cases, we may recommend an X-ray or MRI scan to rule out other conditions such as rotator cuff tears, arthritis, or calcific tendinitis — all of which can produce similar symptoms.

How Physiotherapy Treats Frozen Shoulder

This is where we can make a real difference. Physiotherapy for frozen shoulder at Four Oaks Physio is tailored to the stage you are in — what works in the freezing stage is very different from what is needed during the thawing phase.

Manual Therapy

Hands-on treatment to gently mobilise the shoulder joint, reduce pain, and begin to restore the range of movement. This is particularly effective in the frozen and thawing stages when the capsule begins to loosen.

Medical Acupuncture (Dry Needling)

Our practitioners are accredited by the British Medical Acupuncture Society (BMAS) and the Acupuncture Association of Chartered Physiotherapists (AACP). Medical acupuncture is highly effective at reducing the deep, aching pain associated with frozen shoulder and can help settle inflammation during the freezing stage.

Graded Exercise and Rehabilitation

A carefully progressive home exercise programme — designed around your specific stage and pain levels — is central to long-term recovery. We do not give generic exercises; every programme is built for you.

Postural and Movement Re-education

Poor posture — particularly rounded shoulders and a forward head position — can contribute to shoulder dysfunction and slow recovery. We address the whole kinetic chain, not just the joint itself.

Corticosteroid Injection Guidance

Where appropriate, we work alongside your GP or consultant regarding the timing of corticosteroid injections, which can be particularly helpful in the early freezing stage to settle pain and allow physiotherapy to progress more quickly. The National Institute for Health and Care Excellence (NICE) supports the use of corticosteroid injections in conjunction with physiotherapy for frozen shoulder.

How Long Does Recovery Take?

Frozen shoulder is notoriously slow to resolve without help — left untreated, the full natural history can span 18 months to 3 years. With expert physiotherapy, most patients see meaningful improvement within 8–12 weeks of starting treatment, and many achieve full or near-full recovery significantly faster than the natural timeline would suggest.

The key is starting treatment early — ideally in the freezing stage — rather than waiting to see if it improves on its own.

Frozen Shoulder or Something Else? How to Tell

Shoulder pain is not always frozen shoulder. Other common causes include:

Rotator cuff tears — typically cause weakness and pain with specific movements, but passive movement (where the physiotherapist moves your arm) is less restricted
Calcific tendinitis — calcium deposits causing acute, severe pain
Shoulder impingement — a painful arc of movement rather than global restriction
Cervical radiculopathy — neck problems referring pain into the shoulder and arm

A thorough assessment at Four Oaks Physio will identify exactly what is causing your shoulder pain and ensure you receive the right treatment from the outset.

Why Choose Four Oaks Physio for Frozen Shoulder Treatment?

At Four Oaks Physio in Sutton Coldfield, our Chartered Physiotherapists bring over 25 years of clinical experience in musculoskeletal physiotherapy, including frozen shoulder at every stage of its progression.

We are fully registered with:

We offer both clinic appointments at our Four Oaks clinic on Harcourt Drive, and home visit physiotherapy across Sutton Coldfield, Walsall, Lichfield, Tamworth, and the wider Birmingham area — ideal for patients in significant pain or with limited mobility.

No GP referral is needed. You can book directly and be seen quickly, without waiting for an NHS referral.

We also work with most major health insurers including AXA Health, BUPA, Aviva, and Simplyhealth.

Ready to Get Your Shoulder Moving Again?

Don’t wait for frozen shoulder to resolve on its own. Early physiotherapy makes a measurable difference to both your pain levels and how quickly you recover.

📞 Call us on 07894 988812 📧 Email info@fouroaksphysio.co.uk 🌐 Book your appointment online

We are based at 10 Harcourt Drive, Sutton Coldfield, B74 4LJ and serve patients across Four Oaks, Mere Green, Little Aston, Streetly, Walmley, Wylde Green, Erdington, Walsall, Tamworth, and Lichfield.

References & Further Reading

National Institute for Health and Care Excellence (NICE). (2024). Shoulder pain — frozen shoulder. nice.org.uk
Chartered Society of Physiotherapy (CSP). Frozen shoulder — treatment and recovery. csp.org.uk
Diabetes UK. Frozen shoulder and diabetes. diabetes.org.uk
British Medical Acupuncture Society (BMAS). Acupuncture for musculoskeletal pain. medical-acupuncture.co.uk – (Adhesive Capsulitis) — Zuckerman JD. Frozen Shoulder. New England Journal of Medicine, 2011.

Frozen Shoulder: What It Is, Why It Happens, and How Physiotherapy Can Help You Recover