Frozen Shoulder

What is frozen shoulder?

Frozen shoulder, also known as adhesive capsulitis, is an extremely painful and debilitating condition of unknown cause. It is characterized by pain and stiffness of the shoulder joint and surrounding soft tissue structures.

Frozen shoulder facts

Frozen shoulder affects approximately 2-5% of the adult population

Commonly diagnosed in individuals between the ages of 40 and 70

60% of individuals affected by frozen shoulder are women.

Frozen shoulder is ten times more common in patients with Type 1 diabetes

Approximately 15% of patients develop bilateral frozen shoulder which usually occurs within five years of original diagnosis

The non dominant arm is more often affected

Frozen shoulder can last up to 30 months if left untreated.

Can occur after surgery

Frozen shoulder progresses through three distinct but overlapping clinical phases.

Clinical phases

Phase One- The painful “freezing” phase

Marked by a gradual onset of diffuse pain

Night pain is a feature of this phase

Diagnosis of frozen shoulder at this stage may be uncertain

Generally a poor response to non steroidal anti inflammatory drugs.

1-8  months duration

Phase Two – The stiff “frozen” phase

Characterised by less constant pain but increased restriction in range of motion at the shoulder joint

The dysfunctional movement pattern of the shoulder known as the capsular pattern is most evident in this phase with external rotation most limited, abduction next with medial rotation least limited

Daily activities become increasingly difficult with sharp pain experienced at end ranges of movement

9-16 months duration

Phase Three- The resolving “thawing” phase

A gradual improvement in functional range of motion

A continuing reduction of pain

12-30 months duration

What is the Niel-Asher Technique?

Simeon Niel-Asher, Osteopath and founder of the Niel-Asher Technique

developed his frozen shoulder treatment protocol in 1998.  There are now over 200 licensed Niel-Asher practitioners in the UK, Europe and the USA. For more information visit

The Niel-Asher Technique involves the neuromuscular technique of trigger point therapy combined with a sequence of stretching and specific manipulations to the shoulder joint and soft tissues to combat pain and stiffness

The initial phase of the treatment is designed to significantly reduce the pain, by treating the swelling around the various shoulder tendons. The technique goes on to improve the shoulder range of motion by stimulating a sequence of reflexes hidden within the muscles.

 The Niel-Asher technique can also be used and adapted to treat rotator cuff problems, biceps tendonitis, bursitis and arthritis.

Recommended frequency of treatments and expectations

Phase one “freezing” – approximately 12 sessions Once a week for 3 weeks, then fortnightly, then once every 3 weeks.

3-5 sessions to lessen the inflammation (measured by less or no night pain)

5-7 sessions to regain range of motion

Phase two “frozen” – approximately 8 sessions Once a week for 3 weeks, then fortnightly for 3 sessions, then monthly or more if required.

3 sessions to lessen the inflammation

3-5 sessions to regain range of motion

Phase three “thawing” – approximately 4-7 sessions  Once a week for 4-7 sessions or more often (every 3-4 days) if required.

As a rule 85% of cases can usually be treated in less than 8-10 sessions. 


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Our Arthritis Support Team use acupuncture, nutritional advice and specialist massage to help relieve joint pain and other symptoms associated with osteo, psoriatic and rheumatoid arthritis.  Where the only options often open to arthritis sufferers are painkillers or surgery, our team can support you and manage your condition.  Acupuncture & massage work by reducing swelling and heat symptoms thereby increasing range of movement and decreasing pain.  Nutritional therapy will reduce the body's inflammatory response and increase general energy levels.

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