Frozen Shoulder: Causes, Treatment Options, and When Surgery Is Needed

If you’re experiencing persistent shoulder pain and stiffness that seems to be getting worse over time, you may be dealing with frozen shoulder, also known as adhesive capsulitis. This condition can make simple daily tasks — like reaching overhead, fastening a seatbelt, or putting on a jacket — painful and frustrating.

At Plano Orthopedic & Sports Medicine Center (POSMC), our board-certified orthopedic specialists help patients throughout Plano and North Texas diagnose and treat frozen shoulder with personalized, evidence-based care. Here’s what you need to know about the causes, treatment options, and when surgery may be necessary.

What Is Frozen Shoulder?

Frozen shoulder is a condition where the capsule surrounding the shoulder joint becomes thickened, tight, and inflamed, leading to pain and significant loss of motion. Over time, scar tissue forms inside the joint capsule, restricting movement even further.

Frozen shoulder typically develops in three stages:

1. Freezing Stage

Gradual onset of pain
Increasing stiffness
Difficulty sleeping due to shoulder discomfort

2. Frozen Stage

Pain may decrease slightly
Severe stiffness remains
Limited range of motion

3. Thawing Stage

Gradual improvement in motion
Decrease in stiffness
Slow return to normal function

This process can last anywhere from several months to two years if left untreated.

What Causes Frozen Shoulder?

In many cases, the exact cause is unknown. However, several risk factors increase the likelihood of developing frozen shoulder:

Diabetes (both Type 1 and Type 2)
Thyroid disorders
Prolonged shoulder immobilization after injury or surgery
Rotator cuff injuries
Stroke or neurological conditions
Age between 40–60 years
More common in women than men

After a shoulder injury or surgery, avoiding movement due to pain can increase the risk of the joint capsule tightening and forming adhesions.

Symptoms of Frozen Shoulder

Common symptoms include:

Dull or aching shoulder pain
Stiffness that worsens over time
Difficulty lifting the arm overhead
Limited external rotation (turning the arm outward)
Pain that radiates down the upper arm
Disrupted sleep due to discomfort

If your shoulder pain and stiffness persist for several weeks or worsen instead of improving, it’s time to seek evaluation.

How Is Frozen Shoulder Diagnosed?

At POSMC, diagnosis begins with a thorough physical examination and review of your medical history. Your orthopedic specialist will evaluate:

Active range of motion (how you move your shoulder)
Passive range of motion (how your doctor moves it)
Pain levels and movement limitations

Imaging studies such as X-rays or MRI may be used to rule out other conditions like arthritis or rotator cuff tears.

Non-Surgical Treatment Options

Most cases of frozen shoulder improve without surgery. Early diagnosis and structured treatment can significantly shorten recovery time.

1. Physical Therapy

Targeted stretching and strengthening exercises are the foundation of treatment. Physical therapy helps:

Restore range of motion
Reduce stiffness
Prevent further capsule tightening

2. Anti-Inflammatory Medications

NSAIDs can help reduce inflammation and relieve pain, making therapy more tolerable.

3. Corticosteroid Injections

Steroid injections into the shoulder joint can significantly reduce inflammation and improve pain, particularly during the early “freezing” stage.

4. Activity Modification

Avoiding movements that aggravate pain while maintaining gentle mobility is essential.

At Plano Orthopedic & Sports Medicine Center, we customize treatment plans to fit your stage of recovery and lifestyle needs.

When Is Surgery Needed for Frozen Shoulder?

Surgery is rarely the first option. However, it may be recommended if:

Severe stiffness persists after several months of conservative treatment
Pain remains debilitating
Range of motion fails to improve with therapy
Daily function is significantly impaired

Surgical Options

Manipulation Under Anesthesia (MUA)

While you are under anesthesia, the surgeon carefully moves the shoulder to break up adhesions and improve mobility.

Arthroscopic Capsular Release

This minimally invasive procedure uses a small camera and specialized instruments to cut through tight portions of the joint capsule, restoring motion.

Most patients experience significant improvement following surgery, especially when combined with immediate post-operative physical therapy.

Why Early Treatment Matters

The longer frozen shoulder goes untreated, the longer recovery may take. Early intervention can:

Reduce pain faster
Shorten the duration of stiffness
Improve overall outcomes
Help avoid surgical intervention

If you’re struggling with shoulder stiffness that isn’t improving, don’t wait.

Expert Frozen Shoulder Care in Plano, TX

At Plano Orthopedic & Sports Medicine Center, our experienced orthopedic physicians and physical therapy team provide comprehensive shoulder care — from conservative treatment to advanced surgical options when necessary.

We focus on restoring mobility, reducing pain, and helping you get back to work, sports, and everyday life as quickly and safely as possible.

If you’re experiencing symptoms of frozen shoulder, schedule an evaluation today at POSMC.com and take the first step toward recovery.

Frequently Asked Questions

How long does frozen shoulder last?
Without treatment, it can last 1–2 years. With early care, recovery time may be significantly shortened.

Can frozen shoulder go away on its own?
It can, but treatment helps reduce pain and prevent prolonged stiffness.

Is surgery common for frozen shoulder?
No. Most patients improve with non-surgical treatments, but surgery may be necessary in severe or resistant cases.

If you are experiencing ongoing shoulder pain or limited mobility, the specialists at Plano Orthopedic & Sports Medicine Center are here to help you move comfortably again.