Medically reviewed by Dr. Steve Matta, DO, MBA, CAQSM
Frozen shoulder, clinically known as adhesive capsulitis, is a condition that causes significant pain and stiffness in the shoulder. Frozen shoulder develops gradually and can take months or even years to resolve. Understanding the 4 phases of frozen shoulder can help to diagnose the condition early in order to ease discomfort, prevent long-term restriction and damage to the joint capsule, or recover thoughtfully.
Traditional treatments for frozen shoulder often focus on symptom relief through pain medication, corticosteroid injections, or even surgery. While these methods may provide temporary relief, they rarely address the underlying causes of inflammation, tissue degeneration, or limited mobility. Options like Platelet-Rich Plasma (PRP) and Stem Cell Therapy, both part of the treatment options offered at Meeting Point Health, are gaining attention for their ability to target the root causes of frozen shoulder. These regenerative treatments support true healing by promoting tissue repair, reducing inflammation, and restoring movement.
In this article, we’ll walk through the 4 stages of frozen shoulder, and explore how regenerative approaches can offer new hope for long-term recovery.
What Is Frozen Shoulder, and What Causes It?
Frozen shoulder occurs when inflammation in the shoulder joint capsule causes the tissues of the joint to become tight and thick. This leads to a “freezing” effect on the shoulder, restricting movement (often severely) and causing pain.
It’s not exactly clear what causes frozen shoulder. It happens most often in people between the ages of 40 and 60, and it affects women more than men. Some particular situations have also been linked to frozen shoulder, including:
- Shoulder injury
- Prolonged immobility of the shoulder after injury or surgery
- Autoimmune or inflammatory disorders
- Hormonal imbalances and fluctuations
- Metabolic conditions such as diabetes and thyroid disease
Related reading: How to Heal a Torn Rotator Cuff Naturally
The 4 Stages of Frozen Shoulder
There are 4 stages of frozen shoulder: pre-freezing, freezing, frozen, and thawing. Each stage shows up differently and requires different treatment.
Stage 1 – Pre-Freezing Stage (Onset)
While many patients experience mild discomfort or pain with movement during the first phase of frozen shoulder, their range of motion remains mostly intact. That makes it easy to dismiss the pre-freezing stage as a mild strain or overuse that can be cured with rest.
Duration
3 weeks to 6 months
Symptoms
- Mild stiffness
- Dull ache in the shoulder or upper arm
- Pain that increases with movement or at night
Pain Level
Some mild pain or discomfort with movement, but not enough to cause restriction.
Recommended Therapies
The pre-freezing stage offers an ideal window for early intervention. Anti-inflammatory therapies—like PRP, low-level laser therapy, or targeted physical therapy—can help slow progression and address root inflammation before stiffness sets in.
Stage 2 – Freezing Stage
The freezing stage is typically the most painful. The shoulder becomes increasingly inflamed and the shoulder joint capsule begins to thicken, causing a steady decrease in movement.
Duration
3-9 months
Symptoms
- Restricted movement
- Significant pain in the shoulder
Pain Level
Severe pain, often restricting mobility.
Recommended Therapies
PRP and stem cell therapy are often recommended in the freezing stage. These regenerative treatments can help to reduce inflammation and prevent the scar tissue that causes a fully frozen shoulder.
Stage 3 – Frozen Stage
Pain often subsides in the frozen stage, but stiffness is at its peak—meaning that mobility is at its worst. This stage of frozen shoulder can last for several months, maybe even up to a year.
Duration
4-12 months
Symptoms
- Severe stiffness in the shoulder or upper arm
- Limited mobility
- Ache or pain with movement
Pain Level
Pain typically decreases from the freezing stage, but stiffness is at its peak.
Recommended Therapies
Once the shoulder locks into place, the best treatments focus on mobility and tissue regeneration. Prolozone therapy is one such treatment, utilizing ozone to repair and strengthen the damaged joints and tissues.
Stage 4 – Thawing Stage
As the shoulder begins to thaw, you will slowly see a gradual return to motion. This phase is the longest of the 4 stages of frozen shoulder, lasting up to two years.
Duration
6 months to 2 years
Symptoms
- Gradual reduction in stiffness
- Increased mobility
Pain Level
Pain continues to fade as the shoulder thaws.
Recommended Therapies
As the body begins to heal, the thawing phase is the ideal time to restore strength and function in the shoulder holistically. Peptide therapy can be particularly effective in a supportive care plan that prioritizes motion restoration with posture retraining and other integrative therapies.
Frozen Shoulder Physical Exercises to Support Healing
Immobility is both a symptom and a cause of frozen shoulder. Gentle, purposeful movement is essential for recovery, especially in the later stages of the condition.
The two exercises below are low-impact, and mobility-focused. They are safe and effective for use with frozen shoulder. The key is consistency—practicing these movements daily, and stopping if you experience pain, supports a steady and intentional recovery.
Exercise 1: Pendulum Swing
Lean forward slightly and let your affected arm hang down. Gently swing the arm in small circles.
Pendulum swings increase circulation and improve passive motion without causing strain on the affected joint.
Exercise 2: Wall Walk
Stand facing a wall and use your fingers to “walk” your hand upward. Stop when it becomes painful.
Wall walks gradually increase range of motion and overhead mobility, but do so in a controlled way to ensure gentle improvement.
Gentle Frozen Shoulder Stretches to Restore Range of Motion
Stretching is just as essential as movement in preventing long-term stiffness and regaining full mobility in the shoulder. The two stretches below are ideal for use in the latter stages of frozen shoulder (frozen and thawing). While they can be used in the early stages, it’s best to do so only with the guidance or recommendation of a physician to prevent further damage.
As you stretch, be sure to breathe deeply and stop, or back down, the stretch, if it causes pain. Pushing through the pain often makes the situation worse, not better.
Stretch 1: Towel Stretch
Hold a towel behind your back with one hand above and one below, reaching from above the shoulder and around the lower back. Gently pull up and/or down on the towel, depending on comfort.
The towel stretch opens the shoulder capsule and improves internal and external rotation.
Stretch 2: Cross-Body Stretch
Bring your affected arm across your chest, using your other arm to support it. Hold gently.
Cross-body stretches loosen the posterior capsule and improve horizontal mobility.
What to Know About Frozen Shoulder Surgery
Arthroscopic capsular release is a surgical procedure that addresses frozen shoulder by removing scar tissue and releasing tightness in the shoulder capsule. While minimally invasive, this shoulder surgery is best used in severe cases that do not respond to traditional or regenerative care.
Recovery from shoulder surgery can be just as long as, if not longer than, treatment with traditional or regenerative methods. Post-surgical care typically requires months of rehabilitation and physical therapy.
For many patients, non-surgical treatment options, including regenerative treatments like PRP therapy and stem cell therapy, offer the same or better outcomes—without the risk or surgery.
How Meeting Point Health Approaches Frozen Shoulder Treatment
While many treatment providers aim to manage the pain and stiffness associated with frozen shoulder, Meeting Point Health takes a more holistic approach. An in-depth evaluation helps us to determine the root cause of your pain—whether hormonal changes or injury—and create a customized treatment plan that addresses frozen shoulder at all possible levels.
At Meeting Point Health, we’ve helped many patients avoid shoulder surgery through regenerative and integrative therapies like PRP, stem cell treatments, functional movement rehab, and anti-inflammatory care. Surgery may be an option—but it’s often not the only one. When you treat the body as a whole, healing is possible without surgery or excessive pharmaceuticals.
To learn more, schedule a discovery call or request more information from our team.
Excellent people, very detailed. I’m a USA Boxing Instructor. I have issues with my shoulders from holding the punching mitts. Before I walked into their office, I could barely lift my arms, I walked out ready to fight 12 rounds!! Thank you again, very grateful. – Anthony Panto
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Helpful links:
- Shoulder pain treatment in Philadelphia
- PRP therapy in Philadelphia
- Stem cell therapy in Philadelphia
Frozen Shoulder FAQ
Below are some of the most common questions we get regarding frozen shoulder.
What Are the Red Flags for Frozen Shoulder?
Some of the most common early symptoms of frozen shoulder include:
- Pain that gets worse at night
- Gradual but progressive loss of shoulder mobility
- Difficulty doing routine tasks (brushing hair, reaching overhead)
- Increasing pain over time without a clear reason or injury
If you experience any of these symptoms, especially if you’ve recently had an injury to the shoulder, consult with a doctor as soon as possible. Early intervention can help prevent the condition from worsening.
What Aggravates a Frozen Shoulder?
Common aggravators for frozen shoulder include:
- Inactivity or total immobilization
- Overexertion or aggressive stretching
- Stress
- Poor posture
- High-sugar or pro-inflammatory diets
Anti-inflammatory nutrition, acupuncture, and myofascial release can all help to reduce inflammation in the body and prevent frozen shoulder.
Is Frozen Shoulder Related to a Rotator Cuff Tear?
While frozen shoulder can develop after an injury like a rotator cuff tear or surgery, they are not directly related. Frozen shoulder is caused by inflammation. It is also closely correlated with prolonged immobility—common by necessity after an injury or surgery—but it is not caused by the surgery or injury itself.
