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What is Frozen Shoulder?
Frozen Shoulder (adhesive capsulitis, scapulohumeral periarthritis) is a condition in which the shoulder joint capsule becomes inflamed, thickens, and contracts, leading to significant restriction of mobility and severe pain.
The disease affects 2-5% of the population, more commonly women aged 40-60 years. Without treatment, the "frozen" state can last 1 to 3 years, significantly reducing quality of life. In 20-50% of patients, full mobility is not restored even after years.
Three phases of the disease:
- "Freezing" phase (2-9 months) — increasing pain, gradual restriction of movement
- "Frozen" phase (4-12 months) — pain decreases, but stiffness is maximal
- "Thawing" phase (5-24 months) — slow restoration of mobility
Risk factors:
- Diabetes mellitus (5 times higher risk)
- Thyroid diseases
- Immobilization of the shoulder after injury or surgery
- Female gender, age 40-60 years
- Heart diseases, stroke
Facts about Frozen Shoulder
- ICD-10: M75.0
- Prevalence: 2-5% of the population
- Gender: women 2-4 times more often
- Age: 40-60 years
- In diabetes: up to 20% of patients
- Duration: 1-3 years without treatment
Symptoms of Frozen Shoulder
Pain syndrome
- Deep aching pain in the shoulder
- Sharp pain on attempted movement
- Severe nighttime pain (impossible to sleep on the side)
- Pain radiates into the arm to the elbow
Restricted mobility
- Unable to raise arm overhead
- Limited external rotation (combing hair)
- Limited internal rotation (fastening bra)
- Movements restricted both actively and passively
Impact on Life
- Unable to dress independently
- Difficulties with hygiene
- Inability to work (for many professions)
- Sleep disturbances
- Depression and anxiety
Frozen shoulder (adhesive capsulitis): treatment options and what is known about them
The treatment plan is made by the clinic doctor after an examination and a review of your images. The table shows the options usually discussed for this diagnosis and how well they have been studied.
| Option | What to expect | How well studied |
|---|---|---|
| Exercise therapy and physiotherapy | Reduces pain, strengthens muscles, improves function; the basis of treatment | Moderate evidence |
| Corticosteroid injection | Quickly reduces inflammation and pain, the effect is often temporary; frequent injections are undesirable | Well studied, recommended |
| Painkillers and NSAIDs | Ease pain during flare-ups; long-term use is limited by side effects | Moderate evidence |
| PRP / CGF | Concentrate from your own blood; may reduce pain, growth of new tissue has not been shown | Little data |
| Arthroscopic capsular release | If conservative treatment does not help or there is an indication | When indicated — the doctor decides |
We send your request to several partner clinics. Some will suggest conservative treatment or injections, others surgery; each clinic quotes its own conditions and price. We help you compare the options.
Regenerative methods: realistic expectations
Frozen shoulder usually resolves on its own, but slowly — over 1–3 years. In the early stage, a corticosteroid injection into the joint combined with stretching exercises helps most. There is little data on PRP.
When surgery is discussed. If movement does not return after 6–12 months of treatment, hydrodilatation, manipulation under anaesthesia or arthroscopic capsular release are discussed.
If an injection helps, the effect usually builds up over 6–12 weeks, and the result is assessed after 2–3 months. No clinic can guarantee a result.
Good to know: diagnosis, self-help, outlook
How to tell frozen shoulder from similar conditions
In adhesive capsulitis both active and passive movements are limited, especially external rotation, even with help from the other hand. It most often affects people aged 40–60, women, and patients with diabetes and thyroid disease. In rotator cuff disease passive movement is preserved, and in osteoarthritis the X-ray shows joint changes. The X-ray is normal in capsulitis; the diagnosis is clinical.
What you can do yourself
In the painful phase: gentle exercise within tolerable pain, heat and painkillers as prescribed. When pain settles, gradually increase capsular stretching. Forced painful stretching in the acute phase only increases inflammation.
Outlook and timelines
The condition passes through “freezing”, “frozen” and “thawing” phases and lasts 1–3 years; in most people motion returns fully or almost fully. An intra-articular corticosteroid injection reduces pain and speeds recovery in the first months. For persistent stiffness, hydrodilatation or arthroscopic capsular release is discussed.
Who it is not suitable for and possible risks
Contraindications
- Active infection — at the injection site or systemic, with fever.
- Active cancer or ongoing chemotherapy.
- Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
- Pregnancy and breastfeeding — the procedure is usually postponed.
- A corticosteroid injection into the same area in recent weeks.
- A complete tendon or ligament rupture with loss of function — surgical repair is usually needed.
Possible risks
- Pain and swelling at the injection site for 1–3 days.
- Bruising where blood or fat tissue is taken.
- Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
- The effect may be absent or smaller than expected.
If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.
Scientific evidence
Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:
- Karjalainen TV et al. Surgery for rotator cuff tears. Cochrane Database Syst Rev, 2019.
- Sheth U et al. Efficacy of autologous platelet-rich plasma use for orthopaedic indications: a meta-analysis. J Bone Joint Surg Am, 2012.
Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised
Frequently Asked Questions about Frozen Shoulder Treatment
RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.
Your MRI (or CT, X-ray) report and the images if you have them, plus a short description of your symptoms and previous treatment. Send them via the form on the website — the assessment is free and without obligation: the coordinator replies within 24 hours, and the clinic physician’s preliminary opinion follows in 1–3 business days.
The cost depends on the method, the diagnostics needed and the clinic itself: prices differ between clinics. We request offers from several clinics and send you their conditions and quotes so you can compare. Price guidance is on the treatment cost page. For an outpatient procedure, 2–3 days in Munich are usually enough: examination, procedure and follow-up visit.
Clinic and method matching — free of charge
Describe your case and attach your MRI report. We will identify clinics that use the relevant methods and forward your request to them. No obligation; we reply within 24 hours.
Send a request