Frozen Shoulder Is the Joint Condition Anyone Over 40 Should Know About

Women, in particular, are more at risk of developing this painful problem.

January 29, 2025

Imagine if one morning, you casually reached back to hook your bra only to be greeted with a jolt of pain in your shoulder. And then instead of going away, the pain gradually got worse over time, to the point that you had to invent creative and weird ways to deal with your bra—and putting on a shirt, and washing your hair, and any number of mundane daily tasks. Imagine if, eventually, you were so afraid to move your shoulder, it just got kind of…stuck.

That’s frozen shoulder, or what doctors (less dramatically) call adhesive capsulitis. It’s a mysterious condition, since there’s usually no specific injury that causes it, Sara Edwards, MD, an orthopedic surgeon at the University of California San Francisco, tells SELF. What is clear: Frozen shoulder is common, particularly among women in their 40s and 50s (right around the time that perimenopause begins), and it can be seriously debilitating—taking months to years to finally go away. Yet hardly anyone is talking about it.

“That’s what I’m struck by,” Dr. Edwards says. “I see at least one patient a day who has frozen shoulder, and most have never heard of it before.”

Here’s a primer on the signs of a deep freeze ahead, and what to do about it.

Frozen shoulder 101

Frozen shoulder is caused by trouble in the joint capsule, Gabriella Ode, MD, a sports medicine specialist and surgeon at the Hospital for Special Surgery, in New York City, tells SELF. The shoulder joint capsule is basically a pocket of strong ligaments and lubricating synovial fluid that anchors and stabilizes the upper arm bone within the shoulder socket. With frozen shoulder, this capsule first becomes inflamed and thickened, which leads to stiffness and pain. Over time, bands of scar tissue can form—looking like “little cobwebs,” Dr. Edwards notes—while the synovial fluid may dry up too. Together, those conditions make it superhard to move your arm.

In some cases, Dr. Ode says, frozen shoulder follows an injury or surgery that keeps you from moving the joint (what doctors call “secondary” frozen shoulder). Usually, though, frozen shoulder just happens with no identifiable cause.

Who gets frozen shoulder?

Around 5% of the population develops frozen shoulder, but it’s up to four times more common among women than men. And, as mentioned, women between the ages of 40 and 60 are particularly vulnerable.

Many experts suspect that the hormonal changes of perimenopause are at least part of the explanation, Dr. Edwards says. “We do have estrogen receptors in our joints,” she points out, “and estrogen has anti-inflammatory effects.” Changes in estrogen levels during this time can contribute to an increase in inflammation, which is at the root of frozen shoulder.

The problem is, not much research has been done on the subject. One small study did find that women who used menopausal hormone replacement therapy (HRT) were about half as likely as non-users to have frozen shoulder (3.95% versus 7.65%). But this area of research is in its early days, Dr. Edwards says, and no one has proven that taking hormones can ward off frozen shoulder. The study experts note that these results are preliminary and should spark more studies to determine if HRT is truly protective.

Some other higher-risk groups include people with diabetes or thyroid disease, Dr. Ode says. It’s not clear why, but researchers speculate that the inflammation caused by those diseases might be one reason.

The three stages of frozen shoulder

Generally, doctors divide frozen shoulder into three phases:

The freezing stage. First, there’s pain. Dr. Edwards says her patients often describe it as a dull throbbing in the shoulder that turns into a sharp argh when they move the affected arm certain ways—typically reaching overhead or to the back (the bra-hook scenario is a classic). It’s also common for the pain to worsen at night, Dr. Ode says. As this phase progresses (typically over the course of six weeks to nine months), the pain slowly intensifies, making it harder to move your arm.
The frozen stage. At this point, the pain might lessen, but the shoulder remains stubbornly stiff. The frozen stage typically lasts four to six months (or sometimes longer). A “hallmark” of frozen shoulder, Dr. Edwards says, is that you have trouble moving it yourself and so does someone else, because there’s a physical blockage.
The thawing stage. Finally, the pain and stiffness gradually loosen their grip. Unfortunately, it might feel like an iceberg melting: The thaw can take six months to two years—or longer for some people.

Hillary Jackson, a dance teacher who lives outside New York City, is one of the “lucky” ones. She tells SELF that her frozen-shoulder saga, from initial symptoms to mostly getting back to normal, lasted about six months.

Jackson first noticed something was wrong with her right shoulder in early 2017, when she was 48. It started as pain that mainly struck when she reached up, say, to wash her hair (though she does remember having to change her usual side-sleeping position too). “That’s why you can live with it for so long,” Jackson says. “You think, Well, if I just don’t do the things that hurt, then I’m good.”

Then one day while walking a dog (not her own), Jackson hit a point that was hard to ignore. “If the dog lunged on the leash and pulled my arm forward, it was searing pain,” she recalls. “It felt like my arm was going to rip off my body, but there was something pinning it down, like glue.” As one does, Jackson went online, where she learned about frozen shoulder. She decided it was time to see a doctor.

How frozen shoulder is diagnosed and treated

The best time to address frozen shoulder is, well, before it’s frozen. Treating the pain and regularly moving your shoulder during the “freezing” stage will help you function better—and might help speed the thaw, Drs. Edwards and Ode say. Pain that’s not improving in about a month or a noticeable drop in your shoulder’s range of motion both warrant a doctor’s appointment, Dr. Edwards advises.

Orthopedic specialists generally diagnose frozen shoulder based on symptoms and a physical exam, Dr. Ode says—though she always gets an X-ray, too, to rule out problems like arthritis.

Fortunately, most people with frozen shoulder need only low-tech treatments: Over-the-counter anti-inflammatories (ibuprofen, naproxen) and physical therapy to learn exercises to stretch and mobilize the shoulder are the usual go-to’s. If the pain won’t let you exercise, Dr. Ode says, cortisone injections into the shoulder can help: In fact, some research suggests the combo of cortisone and exercise is especially effective for frozen shoulder.

When those tactics aren’t enough, another option is hydrodilation, where the doctor injects sterile water or saline into the joint capsule. Dr. Ode likens it to “expanding a water balloon,” and the goal is to free up some space in the constricted capsule.

The last resort is surgery, which basically aims to “release” the tight spaces in the joint capsule. Drs. Edwards and Ode say they rarely turn to surgery, reserving it for patients whose shoulders aren’t getting better after at least a year of non-surgical treatment.

Why movement matters

Throughout the process, it’s important to keep moving (within a range you can manage) every day. “So many patients come in already wearing a sling they bought at the drugstore,” Dr. Edwards says. “But by doing that, the shoulder only gets stiffer. We do encourage patients to keep moving the joint.” Drs. Edwards and Ode recommend seeing a physical therapist, who can teach you exercises and stretches that are both safe and beneficial for frozen shoulder.

Jackson says that despite her pain, it was important to her to get back to dancing, where she could move “in a joyful way” again. She decided to work with a teacher whose movement style she knew inside and out, so she could easily modify it to suit her limited range of motion. And continuing to move ended up making a difference: Before long, she says, the thaw began.

Since frozen shoulder doesn’t get as much attention as many other joint conditions, Dr. Ode says it’s not necessarily the first diagnosis that pops into a doctor’s mind. So feel free to speak up if you suspect that’s what’s going on. “You can bring it up,” Dr. Ode says. “‘Could this be frozen shoulder?’ ‘How can we rule this out?’” Even though there’s no quick fix, getting the right diagnosis and treatment could definitely make daily life easier while you wait for things to warm up.