Symptoms and tests
When your arm will not lift easily: could it be frozen shoulder?
Why the shoulder becomes stiff, how frozen shoulder differs from a rotator cuff tear, and how to restore movement while managing pain.
At a glance
- Assess both stiffness and strength to distinguish frozen shoulder from a tendon injury.
- Move the shoulder within a comfortable range and adjust intensity according to pain after exercise.
- Monitor sleep and daily activities as well as the length of recovery.
If your shoulder feels stiff and lifting your arm is difficult, first find out why movement is restricted. Treatment for frozen shoulder usually focuses on controlling pain and gradually restoring the shoulder's range of motion.
Three things to check when the shoulder becomes stiff
Where does it hurt?
Pain around the shoulder or at night does not establish the cause on its own.
Is it stiff with help too?
Compare movement on your own with movement when someone helps you.
Weakness after an injury?
If you cannot lift the arm immediately after an injury, first have the injury assessed.
A guide comparing shoulder pain, range of motion, and weakness after an injury
Frozen shoulder affects the capsule around the joint
A thin, flexible capsule surrounds the shoulder joint. In frozen shoulder, this capsule becomes thicker and tighter, making it difficult to raise the arm or turn it outward. Washing your hair, getting dressed, or reaching into a back pocket may become uncomfortable. The condition often develops between the ages of 40 and 60, but age alone does not establish the diagnosis. It can also occur in people with diabetes or thyroid disease, or after an injury has kept the shoulder from moving for a prolonged period.
During an examination, the clinician compares how far you can move your arm yourself with how far it moves when someone helps you. A reduction in both ranges is an important feature of frozen shoulder. Difficulty lifting the arm does not always mean frozen shoulder. Tendon injuries, arthritis, and nerve problems originating in the neck can also cause shoulder pain, so the location of pain, strength, and movement are assessed together.
Night pain alone does not distinguish it from a tendon tear
Both frozen shoulder and rotator cuff tears can cause pain at night and discomfort when lying on the affected side. The rotator cuff consists of tendons needed to lift and rotate the arm. A tear often causes weakness when lifting the arm. Stiffness may be more prominent than weakness in frozen shoulder, but pain itself can make it difficult to use your strength. No single symptom is enough to determine the cause.
If you suddenly cannot lift your arm after a fall or lifting something heavy, seek prompt assessment for a tendon tear or fracture. Forceful stretching may not be appropriate at that stage. Frozen shoulder is often diagnosed through an examination, and not everyone needs an MRI. X-rays can help assess arthritis and other conditions; ultrasound or MRI may be added when a tendon injury is suspected.
Move gently when pain is severe, then gradually increase the range
When pain is severe, move slowly within a comfortable range rather than forcing the arm all the way up. Keeping the shoulder completely still can also worsen stiffness. Practise movements taught by your clinician or rehabilitation professional, and monitor pain that night as well as immediately after exercise. If pain clearly increases after exercise, reduce the range and intensity and adjust the programme.
Suitable movements may include using the other hand to help lift the affected arm, or letting the arm hang comfortably and moving it gently. Which movements to use and how much to do depend on your current pain and the directions that are restricted. Medication or an injection into the joint may reduce pain and make it easier to continue exercising. If you have diabetes, manage your blood glucose alongside treatment and tell your clinician about diabetes and any medicines you take when discussing an injection.
Assess pain and movement separately during recovery
Frozen shoulder is often described in phases: increasing pain and stiffness, persistent stiffness, and a gradual return of movement. However, not everyone recovers in the same sequence or at the same pace. If pain has eased but turning the arm is still difficult, treatment to restore the range of motion may need to continue. If movement has improved slightly but night pain remains, the exercise load and pain treatment should be reviewed.
Recovery can take months to years. AAOS patient information explains that complete recovery may take up to 3 years. This does not mean you should simply wait. Use activities that were difficult, such as getting dressed or washing your face, to assess changes and adjust treatment. If daily activities remain substantially limited despite adequate treatment, discuss whether a procedure to stretch the capsule or surgery is appropriate. Before your appointment, note which directions are difficult, how often pain wakes you at night, and which daily activities cause the most trouble. A small increase in shoulder movement and a practical improvement in getting dressed are separate measures of progress. Recording these changes helps set specific goals and adjust exercise intensity at the next visit.
Common Questions
Will stretching hard despite the pain help me recover faster?
Forceful stretching is not always helpful. Start with gentle movements, particularly when pain is severe, and adjust the range and intensity if pain increases after exercise.
Do I need an MRI to diagnose frozen shoulder?
Examining shoulder movement is the starting point. If another cause, such as arthritis or a tendon injury, is suspected, the clinician may choose X-rays, ultrasound, or MRI.
Will frozen shoulder improve on its own if I wait?
It often improves over time, but recovery can be prolonged. Continuing treatment can help reduce pain and limitations in daily life while restoring movement.
Evidence and references
01When to seek medical care
Each warning sign is a separate reason to seek care. Follow the action below if any one applies.
Emergency department · call 119 in Korea
- Call 119 for sudden breathlessness or chest pain, severe faintness or loss of consciousness. Do not wait for calf swelling to appear.
- Go to an emergency department if you suddenly cannot bear any weight, or if an injured knee swells rapidly or looks deformed. A cold or numb foot after injury also needs immediate assessment.
- Seek emergency care for a hot, swollen and severely painful joint with high fever, shaking chills, confusion or inability to bear weight.
- With back or leg pain, go immediately to an emergency department for new difficulty passing urine, loss of bladder or bowel control, or numbness around the genitals or anus. Severe or rapidly worsening weakness or numbness in both legs also needs immediate assessment.
Same-day assessment
- Arrange assessment today for a newly hot, swollen joint, sudden severe pain, or a knee locked so that it cannot fully straighten. Joint infection can occur without fever.
- Have new swelling or pain in one calf assessed today for a possible blood clot. Call 119 immediately if breathlessness or chest pain develops.
- Severe knee pain or a new limp in a growing adolescent may come from a hip condition such as slipped capital femoral epiphysis. Stop walking and sport and arrange assessment today. Go directly to emergency care if they cannot bear weight.
- Stop running and seek assessment today for new recurring groin pain, pain with walking or at night, or a limp. A femoral neck stress fracture needs to be considered. Keep weight off the painful leg until assessed. Go to emergency care if you cannot bear weight.
Book an outpatient appointment
- If none of the warning signs above is present, book an appointment for pain lasting a few weeks, repeated swelling or reduced daily activity and exercise.