Frozen Shoulder (Adhesive Capsulitis)
Quick summary
Frozen shoulder causes stiffness and severe pain. Ultrasound-guided hydrodilatation and physiotherapy in Oxford can restore movement fast.
Frozen shoulder (adhesive capsulitis) is a painful inflammatory condition in which the shoulder capsule thickens and contracts, limiting movement in every direction. It typically progresses through freezing, frozen and thawing phases over 12–24 months if untreated.
Key takeaways
- Frozen shoulder causes stiffness and severe pain. Ultrasound-guided hydrodilatation and physiotherapy in Oxford can restore movement fast.
- Diagnosed with in-clinic ultrasound alongside clinical examination.
- Treated with a stepped, evidence-based plan — not one-size-fits-all injections.
- Self-referral available — no GP letter required.
Symptoms
- Deep, aching shoulder pain — often worse at night
- Progressive loss of external rotation and elevation
- Difficulty reaching behind the back or overhead
- Pain radiating into the upper arm
Causes & risk factors
- Idiopathic — most cases have no clear trigger
- Diabetes and thyroid disease (significantly increased risk)
- Post-surgical or post-traumatic immobilisation
- Age 40–65, more common in women
Who is most at risk
- Diabetes mellitus (type 1 or 2) — up to five-fold increased risk
- Female sex, aged 40–65
- Thyroid disease or Dupuytren's disease
- Recent shoulder immobilisation, surgery or minor trauma
Differential diagnosis
Conditions that can mimic Frozen Shoulder.
- Rotator cuff tear (weakness rather than stiffness dominates)
- Glenohumeral osteoarthritis (radiographic joint-space loss)
- Calcific tendinitis (severe pain but preserved passive external rotation)
- Cervical radiculopathy referring to the shoulder
How we diagnose Frozen Shoulder
Diagnosis is clinical: characteristic loss of passive external rotation with the elbow at the side is pathognomonic. Diagnostic ultrasound rules out rotator cuff pathology and confirms capsular thickening around the rotator interval.
Treatment options
Ultrasound-guided hydrodilatation
First-line evidence-based treatment. A high-volume glenohumeral injection of saline, local anaesthetic and steroid stretches the tight capsule and rapidly reduces pain.
Guided intra-articular steroid injection
Reduces inflammation in early painful phase; most effective in the first 6 months.
Structured physiotherapy
Capsular stretching, scapular retraining and graded loading, tailored to the phase of disease.
What we look for on ultrasound
Thickening of the coracohumeral ligament (>3 mm), hypervascularity in the rotator interval on Doppler, and restricted glide of the long head of biceps tendon.
When to seek help
Book if shoulder pain is disturbing sleep, movement is worsening month-on-month, or you have diabetes with new shoulder stiffness — early intervention shortens the disease course.
Recovery timeline
Typical timeframes after diagnosis and treatment. Individual recovery varies — your clinician will personalise this plan.
- 1Days 0–7Immediately post-injection
Rapid pain reduction after hydrodilatation. Avoid heavy overhead work; start gentle pendulums.
- 2Weeks 1–6Early rehab
Progressive capsular stretching and scapular retraining under physiotherapist guidance.
- 3Weeks 6–12Strengthening
Restore rotator cuff strength and full active range. Return to swimming and gym work.
- 4Months 3–6Return to full function
Most patients achieve near-full range. A minority may need a repeat injection.
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Related conditions we treat
Explore other musculoskeletal conditions assessed and treated at the clinic.
- Rotator Cuff Injury
- Calcific Tendinitis of the Shoulder
- Hip Osteoarthritis
- Greater Trochanteric Pain Syndrome
- Knee Osteoarthritis
- Tennis Elbow (Lateral Epicondylalgia)
- Golfer's Elbow (Medial Epicondylalgia)
- Trigger Finger
- Thumb Base (CMC) Arthritis
- Carpal Tunnel Syndrome
- Plantar Fasciitis
- Achilles Tendinopathy
Related symptom guides
Patient-friendly guides that describe how shoulder problems typically present.
- Shoulder Pain at Night — Causes & What HelpsWaking with shoulder pain? Learn the most common causes of night shoulder pain, self-care that helps, and when a guided injection is appropriate.
- Clicking or Popping Shoulder — Causes & AssessmentA clicking shoulder is rarely serious on its own — but with pain, weakness or catching it needs assessment. Learn what causes it and what to do next.
- Stiff Shoulder — Can't Lift the Arm OverheadLosing shoulder range — especially reaching overhead or behind the back — often means frozen shoulder or a rotator cuff tear. Learn how they differ and how each is treated.
Related treatments
Ultrasound-guided procedures we use to treat musculoskeletal conditions.
Frozen Shoulder assessment & treatment across Oxfordshire
We treat frozen shoulder patients from across Oxfordshire and the surrounding counties. Two hours of free parking is available directly at the clinic in Botley, OX2.
How we make treatment decisions
Every recommendation at Oxford Injection Clinic is shaped by current UK guidance — including NICE recommendations for musculoskeletal pain, published NHS guidance on injection therapy, and peer-reviewed evidence from British and international MSK medicine journals. We follow a stepped-care model: accurate diagnosis first (clinical examination and diagnostic ultrasound), conservative measures where appropriate, and image-guided injection or referral only when clinically indicated. Consultant physiotherapist Bob Chandran reviews the latest MSK literature and updates our clinical protocols routinely.
Further reading
Recognised UK and international clinical guidance relevant to Frozen Shoulder.
Frequently asked questions
How long does frozen shoulder last?
Without treatment, 18–30 months is typical. Hydrodilatation combined with physiotherapy can reduce this to a few months in many patients.
Is surgery needed?
Rarely. Over 90% of cases resolve with injection therapy and physiotherapy. Manipulation under anaesthetic or arthroscopic release is reserved for refractory cases.
Will a steroid injection alone fix it?
It helps pain but does not stretch the capsule. Hydrodilatation combines both effects and generally works better.
Book a consultation for frozen shoulder
Consultant physiotherapist Bob Chandran (Boobala Chandran Subramanian) leads every clinic. Self-refer today.
Getting here
Easy to reach — and easy to park
We're in Elms Parade, Botley, just a few minutes from Oxford city centre with excellent transport links.
Free parking
2 hours free, right outside
Park directly in front of the clinic in the Elms Parade car park — 2 hours free for patients, no app or ticket needed for short visits.
From Oxford Railway Station
Approx. 1.5 miles (8 min by taxi, 20 min walk). Head west on Botley Road, continue straight across the A34 flyover into Westway, then turn right into Elms Parade.
Nearest bus stop
Elms Parade (Stop B1) — directly outside the clinic. Served by routes 4, 4A, 4B and 4C from Oxford city centre (every 10–15 min).
By car
Junction 8/9 of the A34, exit toward Botley. Postcode OX2 9LG for sat-nav.
Expert MSK care in Oxford
Oxford Injection Clinic is the specialist musculoskeletal service of GB Clinic Oxford, an independent physiotherapy and interventional MSK clinic based in Botley. Our consultants and advanced practitioners assess, scan and treat the full spectrum of joint, tendon, ligament and nerve problems — from acute sports injuries to long-standing arthritis. Every clinician is HCPC-registered and holds post-graduate qualifications in diagnostic ultrasound, injection therapy or advanced musculoskeletal practice.
We believe the fastest route to recovery is an accurate diagnosis on day one. That is why every consultation includes a full history, a hands-on clinical examination and, where useful, a real-time high-resolution ultrasound scan. If an ultrasound-guided injection is likely to help, we can usually perform it in the same visit — no separate trips, no waiting weeks for imaging.
Evidence-based, patient-led
Not everyone needs an injection. Our clinicians follow NICE, BOA and international best-practice guidance to decide when injections, shockwave therapy, hydrodilatation, barbotage or a structured loading programme is the right next step. Where surgery is genuinely the best option we say so, and we can refer to trusted orthopaedic and pain specialists across Oxford, London and the Thames Valley.
Patients travel to see us from Botley, Summertown, Headington, Cowley, Iffley, Abingdon, Witney, Kidlington, Bicester, Didcot, Wallingford, Wantage, Wheatley, Thame, Woodstock, Chipping Norton, Banbury, Henley-on-Thames and Reading. Same-day appointments, evening slots and Saturday clinics are usually available, and free on-street parking is right outside the clinic.