Shockwave therapy for frozen shoulder

The NHS names two main symptoms: pain in your shoulder, which can be worse at night and disturb your sleep, and stiffness in your shoulder, which makes it difficult to move. Reaching up to a shelf, behind your back or across to put on a coat are the movements people usually notice first.

The stiffness is what sets frozen shoulder apart. The joint loses movement even when someone else moves your arm for you, while a painful tendon usually still allows the movement when the muscles are relaxed. That is one reason a clinician examines the shoulder before anything is treated, and why the calcific shoulder tendinopathy page describes a different problem that can look similar.

The NHS explains that frozen shoulder happens when the tissue around the shoulder joint becomes inflamed. It can follow a shoulder injury or an operation that kept the arm still, and it is more common in people with diabetes, although the reason for that link is not clear. Many people develop it with no obvious trigger.

• a shoulder injury
• surgery that stopped you moving the arm for a while
• diabetes, where the NHS advises keeping up with regular diabetes checks

None of those causes is something a machine reverses. Treatment is about controlling pain and keeping as much movement as possible while the joint recovers.

Frozen shoulder is usually described as passing through a painful phase, a stiff phase and a recovery phase, as the joint first becomes sore, then tight, then gradually loosens. The NHS does not put fixed times on the phases. It says frozen shoulder can take months or years to get better, and that the pain and stiffness will usually go away eventually.

That long, self-limiting course is why the evidence for any treatment is hard to read, and why treatments aim to make the journey more bearable and to keep the shoulder moving. A treatment given during the recovery phase can easily take credit for improvement that was already on its way.

As an add-on, possibly. A 2022 systematic review and meta-analysis of 20 randomised trials concluded that shockwave "seems to be beneficial to patients with frozen shoulder by alleviating pain and improving function" and "could be used as an adjunct therapy to routine treatments". It added that the quality of the trials was hampered by significant inconsistency in long-term pain relief and range of movement.

NICE has published no guidance on shockwave for frozen shoulder. Its shoulder assessment covers calcific tendinopathy, a different condition. So the honest position is that extracorporeal shockwave therapy may add something to exercises and physiotherapy in the short term, and should not be sold as a replacement for them.

The NHS approach runs in steps: keep the shoulder moving gently and use painkillers such as paracetamol or ibuprofen, then stronger prescription painkillers or a steroid injection if needed, then shoulder exercises at home and physiotherapy, which usually runs for at least 6 weeks. Specialist options for a shoulder that stays stiff include hydrodilatation, where fluid is injected to stretch the joint capsule, and, rarely, surgery.

London Shockwave Therapy arranges an assessment at one of four UNTIL clubs, where a registered clinician examines the shoulder and discusses whether shockwave is worth adding to that plan. Published London prices checked on 29 September 2026 ran from £85 to £150 a session and £348 to £400 for a course of three, set out on the shockwave therapy prices page. To start, ask about your case.

The NHS recommends gentle shoulder exercises at home, with a referral to physiotherapy if you need more help, and physiotherapy typically lasts at least 6 weeks. The aim early on is to keep the shoulder moving within what the pain allows, with gentle stretches such as letting the arm hang and swing, and reaching movements that stop short of sharp pain.

As the pain settles, the exercises move towards stretching the joint further and strengthening the muscles around it. A physiotherapist sets the pace, because pushing hard into a painful, freezing shoulder tends to flare it.

Both hurt at night and both make reaching difficult, and they take different paths. A rotator cuff problem, including calcific tendinopathy, is a tendon issue: movement is often still possible when someone else lifts the arm. Frozen shoulder is a joint capsule issue: the movement is blocked whoever lifts the arm.

Imaging is often part of telling them apart, and it matters for shockwave in particular. NICE has assessed shockwave for calcific tendinopathy of the shoulder, which has its own page on calcific shoulder tendinopathy, and not for frozen shoulder. A shoulder treated for months without an examination and imaging has been guessed at.

If a stiff, painful shoulder has not improved with painkillers and exercises, an assessment can show what the shoulder is actually doing. London Shockwave Therapy arranges assessments at four UNTIL clubs, with walking times from the TfL journey planner: 280 Bishopsgate, about 7 minutes from Liverpool Street station; 111 Charing Cross Road, about 5 minutes from Leicester Square; 1 Orchard Street, about 8 minutes from Marble Arch; and 30 South Colonnade, about 2 minutes from Canary Wharf.

Every club has a gym floor, so the shoulder exercises that carry on through any course have space and equipment in the same building, and every club opens at 06:00 on weekdays, before a working day at a desk.