Frozen Shoulder Treatment in Bellingham, WA
Adhesive capsulitis causes a slow, painful loss of shoulder motion that can last months to years. Dr. Borys uses ultrasound evaluation, shockwave therapy, and PRP to address the thickened capsule directly — with the goal of reducing pain and shortening how long the condition runs.
Book an initial visitA capsular problem, not just a pain problem
Frozen shoulder — formally adhesive capsulitis — is a condition in which the fibrous capsule surrounding the glenohumeral joint thickens, contracts, and restricts motion in all directions. Unlike rotator cuff problems, which tend to limit specific movements, frozen shoulder reduces the shoulder's entire range: reaching overhead, reaching behind the back, and rotating outward all become painful and restricted.
The condition typically moves through three phases: a painful freezing phase (3–9 months), a stiff frozen phase (4–12 months), and a slow thawing phase (5–24 months). Total duration commonly ranges from 1 to 3 years. Many patients do not fully recover their range of motion without treatment.
It occurs more often in people over 40, women, and those with diabetes or thyroid conditions — and frequently follows a period of shoulder immobility after surgery or injury.
Shockwave and PRP both have randomized trial support for adhesive capsulitis. PRP provides comparable short-term relief to corticosteroid but significantly better outcomes at 3 and 6 months. Shockwave is superior to conventional therapy alone in meta-analysis data and is a strong non-injection option.
Why patients consider this
- Dress, fasten a seatbelt, or reach a shelf without bracing for sharp shoulder pain
- Sleep through the night without waking from shoulder ache
- Move through the freezing and thawing phases with a structured plan rather than just waiting it out
- A treatment approach that supports tissue recovery rather than temporarily suppressing symptoms
- Know exactly what is causing your shoulder stiffness before any treatment begins
What Dr. Borys offers for frozen shoulder
Shockwave Therapy (ESWT)
Radial shockwave delivers acoustic pressure waves to the shoulder capsule non-invasively, reducing pain and improving range of motion without injection or meaningful downtime. Meta-analyses of randomized trials support ESWT as superior to conventional therapy or placebo for adhesive capsulitis — making it a strong first-line option, especially for patients who prefer to avoid injection.
Learn more about shockwave therapyPRP Injection
Concentrated platelets and growth factors from your own blood are injected into the glenohumeral joint or the thickened capsular tissue under ultrasound guidance. Systematic reviews show PRP provides comparable short-term relief to corticosteroid but significantly better outcomes at 3 and 6 months — without the tissue-weakening effects of repeated cortisone.
Learn more about PRP therapyPerineural Injection Therapy
Low-concentration dextrose injected around the superficial nerves supplying the shoulder capsule to quiet sensitized pain signaling. Useful when nerve-driven pain is a prominent component of the presentation and as a complement to other treatments.
Learn more about perineural injection therapyConservative care is still the starting point
Consistent physical therapy, gentle stretching, and activity modification form the foundation of frozen shoulder management. Shockwave and PRP work best as complements to an active rehab program, or when conservative care alone has plateaued.
The phase of the condition matters. During the freezing phase, pain management and gentle movement are the priority. During the frozen phase, progressive stretching and manual therapy can accelerate motion recovery. Shockwave or PRP are most appropriate when a patient has been through consistent conservative care and is not progressing as expected.
Pendulum and range-of-motion exercises
Gentle movement work — particularly pendulum exercises and passive stretching — helps maintain what range of motion remains and is the cornerstone of self-management during the freezing and frozen phases.
Physical therapy
Structured manual therapy and progressive stretching support motion recovery during the thawing phase and are often combined with in-office treatment for better overall outcomes.
Activity modification
Temporarily avoiding positions and loads that provoke sharp pain allows the shoulder to settle, particularly during the painful freezing phase.
Shockwave or PRP when conservative care stalls
When motion loss and pain persist despite consistent rehab and time, shockwave and PRP offer evidence-supported options that can accelerate recovery and reduce the overall duration of the condition.
Research supporting these treatments
PRP Outperforms Corticosteroid at 3 and 6 Months
Meta-analysis of 7 randomized trials (692 participants) found PRP and corticosteroid comparable at one month — but at three and six months, PRP produced significantly better pain relief, shoulder range of motion, and functional scores.
View on PubMed →Radial ESWT Combined with Physical Therapy Outperforms Sham
Randomized controlled trial found radial shockwave combined with physical therapy produced significantly greater reductions in pain and disability than sham plus physical therapy at 12 weeks, with meaningful improvements in shoulder flexion, abduction, and external rotation.
View on PubMed →PRP Superior to Corticosteroid and Physiotherapy at 3 and 6 Months
Systematic review of 11 studies (971 patients) found PRP outperformed both corticosteroid injection and physiotherapy on pain, function, and range of motion at three and six months. The advantage over corticosteroid grew larger at the six-month mark.
View on PubMed →Who tends to benefit most
A reasonable fit if you…
- Have been diagnosed with adhesive capsulitis or have significant, progressive loss of shoulder motion
- Are in the freezing or frozen phase with pain limiting sleep, dressing, and overhead activity
- Have not had lasting relief from physical therapy or a cortisone injection
- Want a treatment approach that supports tissue healing rather than temporary symptom suppression
May not be the right fit if you…
- —Have early-stage stiffness that may still respond to consistent stretching and physical therapy alone
- —Have a different diagnosis causing shoulder stiffness — examination and ultrasound will clarify this before any treatment is offered
- —Need a guaranteed outcome — both shockwave and PRP work gradually and results vary by individual and disease stage
- —Have an active infection, certain blood or platelet disorders, or active cancer (for injection options)
What to expect after your visit
Some soreness after treatment is normal
Mild aching or increased stiffness for a day or two after shockwave is common and typically resolves quickly. After a PRP injection, a few days of shoulder aching is part of the normal inflammatory healing response. Ice and rest are usually sufficient for both.
Continue gentle movement
Pendulum exercises and gentle range-of-motion work should continue after treatment. Immobilizing a frozen shoulder makes stiffness worse — movement at a comfortable level is encouraged.
Avoid anti-inflammatories around injection
NSAIDs such as ibuprofen can blunt the healing response that PRP is designed to support. Avoid them in the days immediately before and after injection unless directed otherwise.
Recovery takes months, not weeks
Adhesive capsulitis is a prolonged condition. Treatment aims to reduce pain, accelerate motion recovery, and shorten the overall course — but full resolution typically takes months. Realistic expectations and a consistent plan are important.
Start with a full shoulder evaluation
An initial visit includes a full shoulder evaluation and diagnostic ultrasound. Dr. Borys will confirm the diagnosis and discuss whether shockwave, PRP, or a combination is appropriate for your stage and presentation.
The information on this page is for general educational purposes only and is not individual medical advice. It is not a substitute for a consultation with a qualified provider. Whether a treatment is appropriate depends on your individual evaluation, and individual results vary.