Frozen Shoulder (Adhesive Capsulitis) is a condition in which the shoulder becomes painful and progressively stiff, making it difficult to move the arm normally.

Typically, frozen shoulder occurs in 3 stages:

1. Freezing stage (painful phase): Increasing pain and decreasing motion.

2. Frozen stage: Pain may lessen, but stiffness is significant.

3. Thawing stage: Movement gradually improves.

The entire process can last months to several years.

Risk factors include

• Age 40–60 years
• Diabetes
• Thyroid disorders
• Recent shoulder injury or surgery
• Prolonged shoulder immobilization
• Perimenopause and menopause in females (see below)

Although frozen shoulder can occur in both females and males, there is emerging evidence to suggest that changes in hormones particularly Oestrogen that occurs during perimenopause and menopause may have a role. We also see higher occurrence in females
during this time.

Recent studies have found:

• Higher rates of frozen shoulder in peri- and post-menopausal women.
• Associations between menopausal symptoms and shoulder pain/stiffness.
• Laboratory evidence suggesting Oestrogen may help regulate the activity of fibroblasts, the cells involved in scar tissue formation (1, 2, 3, 4)

HOW ACUPUNCTURE HELPS

Acupuncture can help reduce pain, improve circulation, relax tight muscles, and support the bodys natural healing processes. When combined with movement exercises, it can help restore shoulder mobility and improve recovery (5, 6, 7).

During the painful & freezing stage:

• Focus on pain reduction and gentle mobility
• Avoid overly aggressive stretching.

During the stiff & frozen stages:

• Acupuncture combined with range-of-motion exercises.
• Techniques such as electroacupuncture may be used.

During the thawing stage:

• Continue acupuncture as needed while emphasizing rehabilitation and strengthening.

For women in perimenopausal or menopausal age range acupuncture treatment may also
focus on supporting hormonal health, as well as those hormonal changes that are increasing recognized as contributing factor to local connective tissue and joint dysfunction.

TREATMENT GOALS

Many patients notice:

• Reduced pain after a few treatments.
• Improved sleep due to less night pain.
• Gradual increases in shoulder movement over several weeks.

Chronic or severe cases often require a more intense course of treatment e.g. 6 – 12 sessions +

RESEARCH

The evidence has become increasingly supportive of acupuncture as an adjunctive treatment for frozen shoulder. Research suggesting it helps reduce pain, improve shoulder movement, and support recovery in people with frozen shoulder.
It also suggests for the best results when acupuncture is combined with stretching and rehabilitation exercises. By helping to regulate pain, improve circulation, and reduce muscle guarding around the shoulder, acupuncture may make it easier to restore normal movement and function.

1. Leafblad N, et al. Adhesive Capsulitis. Physical Medicine and Rehabilitation. Clinics of North America. 2023. 
2. Saltzman E, et al. Is Hormone Replacement Therapy Associated with Reduced. Risk of Adhesive Capsulitis in Menopausal Women. 2023. 
3. Mechanistic Insights into the Anti-Fibrotic Effects of Estrogen via the PI3K-Akt. Pathway in Frozen Shoulder. 2025. 
4. Navarro-Ledesma S. Frozen Shoulder as a Systemic Immunometabolic Disorder: The Roles of Estrogen, Thyroid Dysfunction, Endothelial Health, Lifestyle, and Clinical Implications. 2025
5. Ben-Arie E, et al. The Effectiveness of Acupuncture in the Treatment of FrozenShoulder: A Systematic Review and Meta-Analysis (2020). 
6. Yang et al. Electroacupuncture for the Treatment of Frozen Shoulder: ASystematic Review and Meta-Analysis (2022). 
7. Comparative Effectiveness of Acupuncture-Related Therapies for Frozen Shoulder: A Systematic Review and Network Meta-Analysis (2025)