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
- Recover range of motion faster than the typical 1–3 year natural course
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 (Peng et al., 2026) 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 →PRP vs Hyaluronic Acid vs Corticosteroid for Adhesive Capsulitis
Comparative study (Valencia et al., 2025) of PRP, hyaluronic acid, and corticosteroid injections in adhesive capsulitis. PRP produced comparable or superior outcomes across pain and function measures, with a favorable safety profile relative to repeat corticosteroid use.
View on PubMed →Radial ESWT Combined with Physical Therapy Outperforms Sham
Randomized controlled trial (Sharahili et al., 2025) found radial shockwave combined with evidence-based 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)
Frozen Shoulder Treatment: Common Questions
How is frozen shoulder different from a rotator cuff problem?
Frozen shoulder (adhesive capsulitis) is a contracture of the joint capsule itself — the fibrous lining around the shoulder joint thickens and tightens, restricting motion in all directions. Rotator cuff problems primarily involve the tendons and typically cause pain with specific movements rather than global loss of motion. The distinction matters because the treatment approach differs significantly between the two.
Is shockwave or PRP better for frozen shoulder?
Both have randomized trial support for adhesive capsulitis and are not mutually exclusive. Shockwave is non-invasive and a strong first-line option — particularly for patients who want to avoid injection. PRP targets the capsular tissue directly and has better intermediate-term outcomes than corticosteroid. The right choice depends on your stage, pain level, and degree of motion loss, and will be discussed at your initial visit.
Does cortisone work for frozen shoulder?
Corticosteroid injection often provides useful short-term pain relief in adhesive capsulitis — particularly in the painful freezing phase. However, systematic review data show the benefit over PRP diminishes at 3 and 6 months, and repeated cortisone can weaken capsular tissue over time. For patients who have already had one or more cortisone shots without lasting improvement, PRP or shockwave are the more reasonable next steps.
Can frozen shoulder resolve on its own?
Yes — adhesive capsulitis is often described as self-limiting, meaning it tends to resolve over 1 to 3 years without intervention. However, many patients do not fully recover range of motion, and the painful freezing phase can last a year or more. Treatment aims to reduce pain, improve function, and shorten the overall duration rather than guarantee a cure.
Does Dr. Borys use ultrasound for the injection?
Yes. Ultrasound guidance allows accurate placement into the glenohumeral joint or thickened capsular tissue rather than relying on surface landmarks alone. This improves precision and reduces the risk of missing the target structure.
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.