Frozen shoulder can cause shoulder pain, stiffness, reduced range of motion, sleep disruption, and difficulty reaching overhead or behind the back.
Learn how Dr. Siefferman explains frozen shoulder, why it develops, and personalized treatment options to reduce pain, restore mobility, and improve function.
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Hi, I’m Dr. Jason Siefferman, medical director at Manhattan Pain Medicine. Frozen shoulder is a term that gets thrown around a lot. It’s generally used to describe a shoulder with restricted range of motion. By the book, frozen shoulder is after an infection of some sort, usually a viral illness. It may not present with obvious symptoms.
It could just be a sore throat, but then there’s an inflammatory process that affects the shoulder and causes the ligaments and tendons to freeze up. More commonly though, there’s just some rotator cuff or labral pathology which leads to pain in the shoulder which leads to disuse. Meaning we avoid using the joint because it hurts. And over a period of time of not fully using that range, the shoulder will tighten up. And then of course as the shoulder tightens up, we don’t use the joint as much. We start using the shoulder blade more, which means we’ll start pulling on the neck.
We’ll develop pain in other locations because the shoulder is not being fully used. Regardless if the shoulder range of motion is impaired, we want to understand what’s happening with the joint, why we don’t have full range of motion with the joint. And once we understand that, then we can start to reverse that process and get the range back.
Frozen shoulder, also called adhesive capsulitis, is a shoulder condition that causes pain and progressive stiffness as the shoulder capsule becomes inflamed, thickened, and tight. Patients may have difficulty reaching overhead, reaching behind the back, dressing, lifting, exercising, or sleeping comfortably.
Frozen shoulder often develops gradually and may take many months to improve. In some cases, full recovery can take up to several years. Because shoulder stiffness can also come from rotator cuff injury, arthritis, cervical referral, inflammatory disease, or other soft tissue problems, careful evaluation is important before treatment begins.
At Manhattan Pain Medicine, evaluation begins by confirming whether symptoms truly fit frozen shoulder or whether another shoulder, neck, nerve, inflammatory, or musculoskeletal condition is contributing.
For patients looking for frozen shoulder treatment in Manhattan, MPM evaluates pain pattern, range of motion, stiffness, sleep disruption, prior injury, immobilization, systemic conditions, imaging, and physical therapy response.
Care may include diagnostic ultrasound, ultrasound-guided injections, steroid injections when appropriate, medication management, and coordination with movement-based care. The goal is to reduce pain, preserve motion, and support function through a stepwise plan.
Frozen shoulder is a common cause of shoulder pain and stiffness, but not every stiff shoulder is adhesive capsulitis. Similar symptoms may occur with rotator cuff tears, shoulder arthritis, tendinopathy, bursitis, cervical radiculopathy, inflammatory arthritis, autoimmune-related pain, nerve irritation, or pain after injury or surgery. A patient may also guard the shoulder because movement hurts, which can make the joint feel even more restricted.
MPM’s diagnosis-first approach helps clarify the source of pain before recommending treatment. The evaluation looks at both active motion, which is how far the patient can move the shoulder, and passive motion, which is how far the shoulder can move when assisted. Frozen shoulder often limits both. This distinction can help separate adhesive capsulitis from other shoulder problems that may require a different care pathway.
Frozen shoulder fits most directly within MPM’s Musculoskeletal issues Zone of Expertise, with Autoimmune and Inflammatory relevance when shoulder stiffness appears alongside systemic symptoms, inflammatory pain, or related conditions. This matters because frozen shoulder can look similar to other musculoskeletal and inflammatory problems.
A patient may have adhesive capsulitis, but they may also have rotator cuff disease, arthritis joint pain, tendinopathy, cervical referral, autoimmune-related pain, or undifferentiated connective tissue disease. MPM uses the Zones of Expertise framework to evaluate whether the primary driver appears capsular, tendon-related, joint-related, nerve-related, inflammatory, or part of a broader chronic pain pattern. This helps guide whether the next step should be ultrasound evaluation, injection, movement-based care, medication management, rheumatology coordination, or orthopedic referral.
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The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I’ve suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I’m feeling an improvement in my life. I no longer stay up all night in pain, a...
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I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
Frozen shoulder, also called adhesive capsulitis, is a condition that causes shoulder pain and stiffness when the shoulder capsule becomes inflamed, thickened, and tight. The shoulder capsule surrounds the joint and helps support movement. When it tightens, the shoulder may become difficult to move in several directions. Patients often have trouble reaching overhead, reaching behind the back, dressing, lifting, or sleeping on the affected side. Frozen shoulder usually develops gradually and may take months or longer to improve.
Frozen shoulder often feels like deep shoulder pain with progressive stiffness and reduced range of motion. Patients may notice difficulty reaching overhead, putting on a coat, fastening a bra, reaching into a back pocket, washing hair, or sleeping comfortably. Pain may be worse at night or when the arm is moved suddenly. As stiffness progresses, the shoulder may feel blocked rather than simply weak. Some patients also develop muscle guarding around the neck, upper back, or shoulder blade because the shoulder is not moving normally.
Frozen shoulder can develop without a clear injury, but it is also associated with immobilization, injury, surgery, diabetes, thyroid disease, stroke, heart disease, and some inflammatory conditions. It can occur when shoulder movement is reduced for a period of time, or when inflammation and capsular tightness develop gradually. Not every patient has an obvious cause. MPM evaluates risk factors, prior trauma, systemic conditions, inflammatory symptoms, and other shoulder problems before confirming that adhesive capsulitis is the main diagnosis.
Frozen shoulder is primarily diagnosed through medical history and physical examination. The clinician evaluates shoulder pain, stiffness, active range of motion, passive range of motion, strength, and functional limitations. Frozen shoulder often limits both active and passive shoulder movement. Imaging or diagnostic ultrasound may be used when needed to rule out other causes, such as rotator cuff injury, arthritis, tendinopathy, bursitis, fracture, or other soft tissue problems. Diagnosis-first care helps ensure the treatment plan matches the actual cause of shoulder stiffness.
Frozen shoulder usually limits both active and passive motion, meaning the patient cannot move the shoulder fully and the clinician also cannot move it fully during the exam. A rotator cuff tear may cause pain, weakness, or difficulty lifting the arm, but passive range of motion may be less restricted depending on the injury. These conditions can overlap or be confused with each other. Diagnostic ultrasound, imaging review, and a focused physical exam may help clarify whether stiffness is capsular, tendon-related, joint-related, or referred from the neck.
Frozen shoulder treatment usually focuses on controlling pain and preserving or gradually restoring shoulder range of motion. Options may include physical therapy, range-of-motion exercises, activity modification, medication management, anti-inflammatory medications when appropriate, and steroid injections in selected cases. Movement-based care is often important, but it should be matched to the stage and irritability of the shoulder. If pain is too intense, an ultrasound-guided steroid injection may be considered to help reduce inflammation and allow better participation in stretching or therapy.
Steroid injections may help selected patients with frozen shoulder by reducing inflammation and pain, especially earlier in the painful phase or when pain limits participation in physical therapy. Ultrasound guidance may improve precision when the injection target needs to be clearly identified. A steroid injection is not the entire treatment plan. It is usually most useful when combined with appropriate movement-based care, range-of-motion work, and follow-up assessment. Steroid injections require clinician evaluation and should be used carefully based on medical history, risks, and diagnosis.
You should see a specialist when shoulder stiffness persists, worsens, limits daily function, affects sleep, follows injury or surgery, or does not improve with basic care. Evaluation is also important if symptoms include weakness, numbness, fever, redness, swelling, unexplained weight loss, chest pain, shortness of breath, sudden severe pain, or systemic inflammatory symptoms. Shoulder stiffness may come from frozen shoulder, but it can also reflect rotator cuff injury, arthritis, cervical radiculopathy, inflammatory disease, infection, fracture, neurologic conditions, or referred pain.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
Frozen shoulder, also called adhesive capsulitis, is a shoulder condition that causes pain and stiffness as the shoulder capsule becomes inflamed, thickened, and tight. The capsule surrounds the shoulder joint and helps support motion. When it tightens, the shoulder can become difficult to move in several directions.
Patients often notice trouble reaching overhead, reaching behind the back, putting on a coat, washing hair, dressing, lifting, or sleeping comfortably. Some describe a deep ache. Others feel sharp pain when the arm is moved suddenly. As stiffness progresses, the shoulder may feel blocked or frozen rather than simply sore.
Frozen shoulder often develops gradually. In many patients, the first stage is painful and may affect sleep. The shoulder may become increasingly stiff over time. Later, pain may become less intense, but motion remains limited. Recovery can be slow. Some patients improve over months, while others take one to three years to regain more normal motion.
Frozen shoulder may occur without a clear injury, but several risk factors can increase the likelihood. These include diabetes, thyroid disease, prolonged immobilization, prior shoulder injury, surgery, stroke, heart disease, and inflammatory conditions. A patient who stops moving the shoulder because of pain may also become more stiff over time.
Frozen shoulder is not the only cause of shoulder stiffness. Rotator cuff tears, tendinopathy, bursitis, shoulder arthritis, cervical radiculopathy, inflammatory arthritis, fracture, infection, nerve irritation, and referred neck pain can all create shoulder symptoms. Some patients have more than one problem at the same time.
A key feature of frozen shoulder is loss of both active and passive range of motion. Active motion is how far the patient can move the shoulder. Passive motion is how far the clinician can move the shoulder while the patient relaxes. In adhesive capsulitis, both are often limited. In a rotator cuff problem, the patient may have pain or weakness with active movement, but passive motion may be less restricted.
MPM begins with a detailed history and shoulder examination. This includes pain location, stiffness pattern, sleep disruption, injury history, prior immobilization, surgery, diabetes or thyroid history, inflammatory symptoms, prior physical therapy, medication response, and any imaging already completed.
The physical examination evaluates range of motion, strength, tenderness, shoulder mechanics, neck referral patterns, and signs that may suggest rotator cuff disease, arthritis, bursitis, nerve irritation, or another soft tissue condition. Diagnostic ultrasound may be used when appropriate to assess shoulder structures or guide injection treatment. MRI or X-ray may be reviewed or coordinated when additional information is needed.
Frozen shoulder treatment focuses on reducing pain and preserving or improving motion. Physical therapy and range-of-motion work are often central to care. The therapy plan should match the patient’s stage and pain level. A shoulder that is highly painful may not tolerate aggressive stretching. A shoulder that is less painful but very stiff may need a different approach.
Medication management may help reduce pain or inflammation in selected patients. Anti-inflammatory medications may be considered when appropriate, depending on medical history and risk factors. Steroid injections may be helpful in selected cases, particularly when inflammation and pain are limiting motion or sleep.
An ultrasound-guided steroid injection may be considered when the clinical picture supports frozen shoulder and pain is limiting function or participation in therapy. Ultrasound guidance allows the clinician to visualize anatomy and improve precision when targeting the joint or surrounding structures.
A steroid injection should not be viewed as a stand-alone cure. It may reduce pain and inflammation, but movement-based care is often still needed to preserve and restore shoulder motion. The best plan usually combines pain control, appropriate stretching, functional movement, and monitoring over time.
Frozen shoulder can overlap with inflammatory or systemic conditions. Some patients with autoimmune-related pain, undifferentiated connective tissue disease, arthritis joint pain, or other inflammatory symptoms may develop shoulder stiffness or pain that needs broader evaluation. In those cases, MPM may coordinate with rheumatology or other specialists when systemic inflammation appears to be part of the picture.
This is important because shoulder stiffness related to capsular tightness is treated differently from shoulder pain caused primarily by inflammatory arthritis, neck referral, nerve irritation, or tendon pathology. Diagnosis-first care helps prevent the wrong treatment pathway.
Most frozen shoulder cases are treated without surgery, but orthopedic referral may be appropriate when symptoms are severe, atypical, prolonged, or not improving with appropriate care. Referral may also be needed if imaging suggests structural pathology, if there is significant weakness, or if another shoulder condition is suspected.
MPM approaches frozen shoulder through a diagnosis-first, function-focused model. The evaluation considers adhesive capsulitis, rotator cuff disease, shoulder arthritis, tendinopathy, cervical referral, autoimmune-related pain, undifferentiated connective tissue disease, and complex musculoskeletal pain contributors.
For patients looking for frozen shoulder treatment in Manhattan, MPM offers a careful approach to diagnosis, ultrasound-guided care when appropriate, and coordinated treatment planning. The goal is to reduce pain, support shoulder motion, improve daily function, and ensure the care plan matches the true source of stiffness.
