Frozen Shoulder in Your 50s: What a 2025 Guideline Says About Treatments
Menopause & HormonesArticleFrozen shoulder most often strikes women between 45 and 60, peaking around 56, and the link with menopause is suspected but unproven. A 2025 British guideline found steroid injections help short term, hydrodilatation beats physiotherapy alone in the short to medium term, and manipulation under anesthesia is a reasonable option.
Frozen shoulder, also called adhesive capsulitis, is a painful stiffening of the shoulder that lasts more than three months.1 It most often affects women aged 45 to 60, with a peak around 56.1 Perimenopausal hormone changes are suspected to play a role, but a direct cause hasn’t been proven.1 A 2025 narrative review proposed that falling estrogen and thyroid problems may make it more likely or more severe, but that idea still needs testing.2
Who’s at higher risk
- Diabetes is the strongest link: about 11% of people with diabetes developed frozen shoulder versus about 2% without.1
- Underactive thyroid, high cholesterol and some other conditions are also associated.1
It often moves through painful, freezing and thawing phases.1
What the 2025 guideline found
The British Elbow and Shoulder Society reviewed 116 studies.1
| Treatment | What the evidence shows |
|---|---|
| Physiotherapy alone | Unknown whether it beats letting the condition run its course; group exercise classes may help recovery1 |
| Steroid injection into the joint | Consider for short-term relief; no clear benefit beyond 3 months1 |
| Physiotherapy after an injection | Worth considering; may give short-term benefit1 |
| Hydrodilatation (stretching the joint with fluid) | Better than physiotherapy or supportive care for pain and movement in the short to medium term1 |
| Ultrasound-guided vs. freehand injection | No difference in results1 |
| Manipulation under anesthesia | A reasonable option, chosen through shared decision-making1 |
What this means for you
- Get the diagnosis confirmed, since other shoulder problems can look similar.
- An injection may ease the painful phase so you can move and exercise.
- Ask about hydrodilatation if pain and stiffness persist.
- Check your blood sugar and thyroid if they haven’t been tested recently. Our guide to thyroid and hair covers thyroid symptoms.
Our article on aching joints in menopause covers related pain.
Try: “My shoulder has been stiff and painful for four months and I can’t reach behind my back. Could this be frozen shoulder, and would an injection or hydrodilatation help?”
My Body Changed. Now What? includes a Visit Brief. Use it to note when the pain started, what movements are hard and any other health conditions. See the book.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Please don't ignore professional advice or delay getting care because of something you read here. Shoulder pain with chest pain, shortness of breath or sweating can be a heart problem; call 911. A shoulder injury with sudden loss of movement, fever or a hot swollen joint needs prompt care. If you think you may be having a medical emergency, call 911 or your local emergency number right away. This article discusses a medical condition and a clinical guideline. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- Shoulder and Elbow (full text via PubMed Central), 2025British Elbow and Shoulder Society patient care pathway: Frozen shoulder (opens in a new tab)abcdefghijklm
- Journal of Clinical Medicine (full text via PubMed Central), 2025Frozen Shoulder as a Systemic Immunometabolic Disorder: The Roles of Estrogen, Thyroid Dysfunction, Endothelial Health, Lifestyle, and Clinical Implications (opens in a new tab)↩
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