Shoulder pain can be frustrating, especially when it begins to interfere with everyday activities like reaching overhead, fastening a bra, or even sleeping comfortably. One condition that commonly causes this type of pain and stiffness is frozen shoulder, also known as adhesive capsulitis. Learn more about frozen shoulder, its symptoms and the surprising link to menopause.
Understanding the shoulder joint
Before getting into what a frozen shoulder is, we need to understand how the shoulder functions. The shoulder is one of the most mobile joints in the body, allowing you to lift, rotate, and reach in many directions. It’s a ball and socket joint made up of three bones:
- Humerus — the upper arm bone
- Scapula — the shoulder blade
- Clavicle — the collarbone
The rounded head of the humerus forms the “ball,” which fits into a shallow socket on the scapula called the glenoid. Surrounding this joint is a flexible envelope of connective tissue known as the shoulder capsule. Inside the capsule, synovial fluid helps lubricate the joint so the shoulder can move smoothly and freely.
When this capsule becomes inflamed, thickened, or tight, movement becomes painful and restricted—the hallmark of frozen shoulder.
What is frozen shoulder?
Frozen shoulder occurs when the shoulder capsule stiffens and contracts, limiting the joint’s ability to move. The condition typically develops gradually and progresses through three stages:
1. Freezing Stage
Duration: 6 weeks to 9 months
Symptoms: Increasing pain and a steady loss of shoulder mobility. Many people notice difficulty with daily tasks and worsening nighttime pain.
2. Frozen Stage
Duration: 4 to 6 months
Symptoms: Pain may begin to ease, but stiffness becomes more pronounced. Range of motion is significantly limited.
3. Thawing Stage
Duration: 6 months to 2 years
Symptoms: Gradual improvement in mobility. Some people regain full function, while others may continue to experience mild limitations.
Although frozen shoulder often resolves over time, the process can be lengthy and uncomfortable — which is why early recognition and treatment are so important. Frozen shoulder can happen to anyone. It is estimated that two to five percent of people around the world, or about three million people, will develop frozen shoulder each year. One common cause is not moving the shoulder enough – such as during recovery from an injury, a broken arm, or a stroke. While anyone can develop frozen shoulder, it is particularly common among women between the ages of 40 and 60 — a time when many are transitioning through perimenopause or menopause.
Why is frozen shoulder more common during perimenopause and menopause?
Emerging research points to a strong connection between hormonal changes and the development of frozen shoulder. A 2025 article in the Journal of Clinical Medicine suggests that declining estrogen levels may play a key role. Estrogen has natural anti inflammatory and antifibrotic effects, meaning it helps regulate inflammation and prevents excessive tissue thickening. When estrogen levels drop during perimenopause and menopause, these protective mechanisms weaken, potentially contributing to the stiffening of the shoulder capsule.
Other studies have shown that perimenopausal women frequently experience musculoskeletal pain, joint stiffness, and reduced flexibility, all of which may be linked to fluctuating estrogen levels. For some women, these hormonal shifts create the perfect environment for frozen shoulder to develop.
Women with additional risk factors — such as diabetes, thyroid disorders, a history of shoulder injury, or cardiovascular disease — may be even more susceptible.
Treatment options for frozen shoulder
The good news is that frozen shoulder is treatable, and many women experience significant improvement with the right approach. Treatment often focuses on reducing pain, improving mobility, and supporting the natural healing process.
Active physical therapy
Working with a physical therapist can help restore movement and reduce stiffness. Techniques may include:
- Gentle stretching
- Joint mobilization
- Manual therapy
These approaches can be especially helpful throughout the frozen and thawing stages.
Extracorporeal shockwave therapy (ESWT)
ESWT uses targeted sound waves to stimulate healing in the shoulder tissues. Research shows it may be particularly beneficial for perimenopausal women with diabetes, a group at higher risk for frozen shoulder.
Steroid treatment
Steroids — taken orally or injected directly into the joint — can reduce inflammation and pain. Steroid injections are often most effective early in the freezing stage. A 2024 network meta analysis found that intra articular corticosteroid injections outperformed physical therapy and non-steroidal anti-inflammatory drugs (NSAID) in reducing pain and improving function at 12 weeks.
Hormone replacement therapy (HRT)
Preliminary research suggests that HRT may lower the risk of developing frozen shoulder in menopausal women. While more studies are needed, this early evidence is promising and may be worth discussing with your healthcare provider if you are considering HRT for menopausal symptoms.
When to talk to your provider about frozen shoulder
If you’re between 40 and 60 and notice increasing shoulder pain or stiffness — especially if it interferes with daily activities — it’s a good idea to speak with your primary care provider. Early diagnosis can help you begin treatment sooner, potentially shortening the course of the condition and improving your quality of life.
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