How to Differentiate Between Shoulder Pain and Frozen Shoulder

Shoulder pain is a common complaint that can result from various issues ranging from minor muscle strains to more serious conditions like a torn rotator cuff. However, frozen shoulder is a specific type of shoulder pain that often perplexes both patients and healthcare providers. The term “frozen” doesn’t necessarily imply a cold sensation but signifies a significant loss of motion in the shoulder joint. How can one differentiate between general shoulder pain and frozen shoulder, and when is shoulder pain physiotherapy advised? Let’s explore the nuances of these two conditions.

General Shoulder Pain: Common Causes

General shoulder pain can arise from a multitude of reasons, including:

  1. Muscle Strains: Overexertion or improper lifting techniques can lead to muscle strains.
  2. Rotator Cuff Injuries: These injuries are common in athletes and those engaged in repetitive overhead activities.
  3. Osteoarthritis: This degenerative condition often affects older adults.
  4. Bursitis: Inflammation of the bursa, a sac filled with lubricating fluid, can result in shoulder pain.

Frozen Shoulder: What Is It?

Frozen shoulder, also known as adhesive capsulitis, is characterised by pain and stiffness in the shoulder joint. It generally progresses through three stages:

  1. Freezing Stage: Gradual onset of shoulder pain that worsens over time, culminating in reduced range of motion.
  2. Frozen Stage: The pain might decrease, but the stiffness remains, making daily activities challenging.
  3. Thawing Stage: Gradual improvement in range of motion.

Distinguishing Features


While both conditions manifest as shoulder pain, frozen shoulder also leads to a dramatic loss of shoulder mobility. General shoulder pain does not usually limit movement to the extent that frozen shoulder does.

Onset and Progression

Frozen shoulder often starts with minimal discomfort and gradually escalates over several months. In contrast, general shoulder pain might occur suddenly due to an injury or overuse.

Age Factor

Frozen shoulder predominantly affects individuals between the ages of 40 and 60 and is more common in women. General shoulder pain can occur at any age, depending on the underlying cause.

Associated Conditions

Frozen shoulder is often associated with other conditions like diabetes, heart disease, or a history of surgery or immobilisation. General shoulder pain does not have such specific associated conditions.

Diagnostic Approaches

  1. Physical Examination: A thorough physical exam will provide initial insights into the nature of the shoulder pain.
  2. Imaging: X-rays or MRIs are often more revealing for general shoulder pain than for frozen shoulder.
  3. Range of Motion Tests: These are crucial for diagnosing frozen shoulder. A significant loss of movement is a red flag for this condition.


Shoulder pain physiotherapy can be highly effective for both general shoulder pain and frozen shoulder. However, frozen shoulder often requires a more intensive and longer-term physiotherapy regimen.

Various techniques, including manual therapy, exercise programmes, and lifestyle adjustments, are part of shoulder pain physiotherapy to improve mobility and reduce pain.


While both general shoulder pain and frozen shoulder can cause significant discomfort, they are distinct conditions requiring different diagnostic and therapeutic approaches. Understanding the specific symptoms, progression, and associated conditions can help in seeking timely and appropriate treatment, including shoulder pain physiotherapy. Consulting a healthcare provider for accurate diagnosis and treatment is crucial for effective management and recovery.