Frozen Shoulder (Adhesive Capsulitis): Why early intervention is essential

Frozen Shoulder, medically known as Adhesive Capsulitis, is a painful and often frustrating condition that our physiotherapists help people with daily.  Frozen shoulder affects movement and everyday function and causes signicant pain. It can feel like your shoulder is “stuck,” making even simple tasks—such as reaching for a seatbelt, putting on a coat, reaching behind you or sleeping on your side—difficult and painful. 

Frozen Shoulder, medically known as Adhesive Capsulitis, is a painful and often frustrating condition that our physiotherapists help people with daily.  Frozen shoulder affects movement and everyday function and causes signicant pain. It can feel like your shoulder is “stuck,” making even simple tasks—such as reaching for a seatbelt, putting on a coat, reaching behind you or sleeping on your side—difficult and painful. 

Early diagnosis and the right treatment plan can dramatically shorten recovery time and improve your quality of life- and reverse what can be a VERY long, painful and debilitating condition when left untreated.

This guide explains what Frozen Shoulder is, why it happens, the three classic stages, and how physiotherapy and early intervention options (including hydrodilatation steroid injections) can help.

What Is Frozen Shoulder?

Frozen Shoulder occurs when the capsule surrounding the shoulder joint becomes thickened, inflamed and tight, leading to pain and a progressive loss of movement.

The exact cause is not always clear, but it is more common in people who:

  • Are aged 40–70
  • Have diabetes or thyroid conditions
  • Have had recent shoulder injuries or surgery
  • Have prolonged immobility following illness or trauma

The good news is: most people make a full recovery- when left alone it can take 18months to 2 years to clear up!  So intervening early with diagnosis and hydro-dilatation injection can be a game-changer.

The Three Stages of Frozen Shoulder

1️⃣ Freezing Stage (Painful Phase)

  • Slow onset of deep, aching pain
  • Sharp pain with movement
  • Increasing stiffness
  • Night pain is common

This is often the most uncomfortable stage.

2️⃣ Frozen Stage (Stiff Phase)

  • Pain may lessen
  • Shoulder becomes very stiff
  • Limited ability to lift, reach, or rotate

Daily tasks can feel significantly restricted.

3️⃣ Thawing Stage (Recovery Phase)

  • Gradual return of movement
  • Pain continues to settle
  • Function steadily improves over months

⭐ Why BOOST PHYSIO Recommends Early Hydrodilatation Steroid Injection

Early intervention with a hydro-dilatation injection, with steroid, can dramatically help the recovery of a frozen shoulder. We recommend early consideration of a hydrodilatation steroid injection to our patients, performed by a consultant specialist (we do not perform these injections ourselves; we refer to trusted consultants who do).

What is Hydrodilatation?

Hydrodilatation (also called hydro-distension, or high volume saline injection) is a guided procedure in which a consultant injects:

  • A local anaesthetic
  • A corticosteroid
  • Sterile fluid

into the shoulder joint capsule to help:

  • Reduce inflammation quickly
  • Stretch and expand the tight capsule
  • Break the cycle of pain + stiffness
  • Allow earlier, more effective physiotherapy

Why We Recommend Early Intervention

Early hydrodilatation can:

  • Significantly reduce pain within days
  • Rapidly improve movement
  • Make physiotherapy more comfortable and effective
  • Shorten the overall recovery timeline
  • Prevent the condition from progressing into severe stiffness

Patients often report feeling the shoulder “loosen” within a short period after the procedure, allowing physiotherapy to progress much more efficiently.

We refer to several excellent orthopaedic consultants and sports medicine physicians who perform hydrodilatation under ultrasound guidance, ensuring precision and safety.

How BOOST PHYSIO Helps You Recover

Your physiotherapist will:

  • Assess which stage of Frozen Shoulder you’re in
  • Guide you on the safest, most effective treatment pathway
  • Provide hands-on manual therapy
  • Teach targeted mobility and strengthening exercises
  • Advise on pain management and pacing
  • Support your recovery before and after hydrodilatation (if appropriate)

Frozen Shoulder can feel overwhelming, but with the right approach, you can regain comfort, movement and confidence.

Same-Day Expert Help for Frozen Shoulder

Expert same-day private physiotherapy near me at one of BOOST PHYSIO’s 10 clinics across London and Hertfordshire. Get the treatment you deserve and need nearby in Mill Hill, Elstree, Swiss Cottage, Hampstead, Hendon, East Finchley, Muswell Hill, Borehamwood, Kensington High Street and Hampstead Garden Suburb.

Our physiotherapists will assess your shoulder, guide you through your recovery plan and, if appropriate, arrange a rapid referral for hydrodilatation with our trusted consultant network.