What are the signs and symptoms of each phase of frozen shoulder syndrome (FSS) (adhesive capsulitis)?

Updated: Nov 12, 2020
  • Author: Jefferson R Roberts, MD; Chief Editor: S Ashfaq Hasan, MD  more...
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Answer

The initial painful phase is marked by a gradual onset of diffuse shoulder pain lasting from weeks to months. The stiffening phase is characterized by a progressive loss of ROM that may last up to 1 year. Most patients lose glenohumeral external rotation, internal rotation, and abduction during this phase. The final, thawing phase is measured in weeks to months and constitutes a period of gradual motion improvement. Once in this phase, the patient may require up to 9 months to regain a functional ROM. [6, 7, 8, 9] See Table 1, below.

Table. 1 Stages of Frozen Shoulder Syndrome  (Open Table in a new window)

Stage Duration 
Stage 1 Freezing (painful) 

Up to 9 months

Stage 2 Frozen (stiffening)

4 months - 20 months

Stage 3 Thawing

5 months- 26 months

Contralateral shoulder 6 months - 7 years after initial onset of symptoms 

Patients with diabetes and younger patients may be more likely to develop contralateral idiopathic adhesive capsulitis. [10]


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