Cold Laser Therapy for Frozen Shoulder
Cold Laser Therapy for Frozen Shoulder
Cochrane-reviewed evidence for non-invasive photobiomodulation — may help reduce shoulder pain and improve range of motion
Who gets frozen shoulder?
Frozen shoulder – also known as adhesive capsulitis – affects roughly 2 to 5 per cent of the general population. It is most common between the ages of 40 and 60, affects women more than men, and is significantly more prevalent in people with diabetes. The condition can develop after an injury, surgery or period of immobility, but often appears without any obvious cause.
Tap the one that sounds like you.
Office & Desk Workers
Can’t reach, seatbelt, overhead
Retirees & Older Adults
Dressing, hanging washing, independence
Active Adults & Weekend Warriors
Can’t throw, swim, lift
Nurses & Shift Workers
Patient handling, overhead reach
How Photobiomodulation May Help Frozen Shoulder
What happens in frozen shoulder
Frozen shoulder involves inflammation and fibrosis (thickening) of the joint capsule. The capsule contracts, reducing the volume of the joint space and restricting movement in all directions. This process can be painful, disabling and slow to resolve.
What the research suggests may occur with PBM
- Pain reduction — The Cochrane review found a 19-point pain reduction on a 100-point scale when LLLT was combined with exercise (95% CI 15–23, moderate-quality evidence)
- Improved function — Function improvements were maintained at 4 months in the same trial
- Treatment success — In one trial, 80% of participants reported treatment success with LLLT compared to 10% with placebo (low-quality evidence)
- Broad shoulder evidence — A systematic review of 25 SRs and 44 RCTs found LLLT to be the only modality with moderate evidence for all shoulder conditions — impingement, rotator cuff, adhesive capsulitis and non-specific shoulder pain
How it works at a cellular level
Photobiomodulation may influence the inflammatory component of frozen shoulder and support the biological processes involved in tissue remodelling. By delivering specific wavelengths of light to the shoulder capsule and surrounding structures, PBM may modulate the cellular environment in ways that support recovery alongside exercise.
Individual responses to photobiomodulation therapy vary. Frozen shoulder typically requires a sustained course of treatment. The condition has a natural history of eventual resolution, but this can take 1–3 years without intervention. A thorough clinical assessment is recommended before commencing any treatment plan.
The Evidence Base
Cochrane review of 19 RCTs involving 1,249 participants
Page et al. 2014 — Cochrane Database of Systematic Reviews (1,249 patients)
The gold standard of evidence synthesis for frozen shoulder electrotherapy. This Cochrane review found moderate-quality evidence that LLLT plus exercise for 8 weeks was more effective than placebo plus exercise. Pain was reduced by 19 points on a 100-point scale (95% CI 15–23). Function improvements were maintained at 4 months. In a separate comparison, 80% of participants receiving LLLT alone reported treatment success at 6 days versus 10% in the placebo group. No adverse events were reported in either group.
This is a summary of published research findings. Individual treatment outcomes vary and are not guaranteed.
PMID: 25271097 • DOI: 10.1002/14651858.CD011324
Hawk et al. 2017 — JMPT (25 systematic reviews + 44 RCTs)
A comprehensive review of all conservative, non-drug, non-surgical shoulder treatments. The reviewers found that low-level laser therapy was the only modality with moderate evidence supporting its use across all four common shoulder conditions: impingement syndrome, rotator cuff disorders, adhesive capsulitis and non-specific shoulder pain. This is a significant finding — no other single modality achieved this breadth of evidence.
Individual responses vary. This study’s results may not predict your personal outcome.
PMID: 28554433 • DOI: 10.1016/j.jmpt.2017.04.001
Erdinc et al. 2025 — Am J Phys Med Rehabil (60 patients)
This recent RCT compared LLLT, extracorporeal shockwave therapy (ESWT) and control groups for frozen shoulder. Both LLLT and ESWT improved pain at 3 weeks, but at 12 weeks the LLLT group showed greater improvements in range of motion, overall Constant-Murley score and quality of life measures (physical and emotional role limitations). This suggests that LLLT may offer advantages over other modalities in the medium term.
Individual responses vary. This study’s results may not predict your personal outcome.
PMID: 40857136 • DOI: 10.1097/PHM.0000000000002831
“Low-level laser was the only modality for which there was moderate evidence supporting its use for all 4 [shoulder] conditions.”
Hawk et al., JMPT, 2017 (PMID 28554433)
Our clinical device delivers wavelengths within the ranges used in the published trials. Individual responses vary.
Ready to explore cold laser therapy?
$99 initial consultation includes full assessment and first treatment session. No lock-in plans.
What to Expect
Your first visit ($99)
- Assessment — Dr Sam Johnson (Chiropractor) will assess your shoulder range of motion, pain patterns and functional limitations. This helps determine the stage of your frozen shoulder and whether photobiomodulation is appropriate.
- Treatment — The Multi-Radiance MR5 ACTIV PRO (ARTG-listed, 370913) is applied around the shoulder joint capsule. Treatment is painless. Most people feel a gentle warmth or nothing at all. A typical shoulder session takes approximately 10–15 minutes.
- Exercise guidance — The strongest evidence supports cold laser therapy combined with exercise. Dr Johnson will provide appropriate shoulder exercises based on the stage of your condition. These are typically gentle range-of-motion exercises that work within your current comfortable range.
- Your plan — Frozen shoulder typically requires a sustained course of treatment. Dr Johnson will discuss what may be appropriate based on your assessment findings. No lock-in plans. The decision is always yours.
Ongoing care
- Treatment sessions are typically 10–15 minutes including setup
- The Cochrane review used LLLT combined with exercise for 8 weeks
- Function improvements were maintained at 4 months (Page 2014)
- Ongoing care options are discussed at your initial consultation
- On the Marion Road commuter corridor — convenient before or after work from Plympton Park, Plympton, Park Holme, Glenelg North, Morphettville, Edwardstown, Ascot Park, and Marion
Treatment frequency and duration are individualised based on your clinical presentation and response. The figures above reflect protocols used in published research studies.
⚠️ When to See Your GP Urgently
While frozen shoulder is common and generally manageable, certain symptoms warrant prompt medical attention:
- Sudden shoulder pain after a fall or trauma — may indicate a fracture or dislocation requiring urgent assessment
- Inability to lift your arm at all combined with severe pain — may indicate a rotator cuff tear requiring investigation
- Shoulder pain with shortness of breath, chest pain or jaw pain — cardiac symptoms can refer to the shoulder and require emergency assessment
- Fever with a hot, red, swollen shoulder — may indicate infection requiring emergency treatment
- Unexplained weight loss combined with persistent shoulder pain — while rare, these require investigation to rule out other conditions
If you are unsure whether your symptoms are urgent, please contact your GP or call 13 HEALTH (13 43 25 84) for advice.
Frequently Asked Questions
How long does frozen shoulder last?
The natural history of frozen shoulder varies significantly. Without intervention, the condition typically progresses through three stages — freezing (2–9 months), frozen (4–12 months) and thawing (5–24 months). Total duration can range from 12 months to over 3 years. Some people recover full range of motion; others retain mild restrictions. The Cochrane review found that LLLT combined with exercise may improve pain and function outcomes compared to exercise alone, which may support a more comfortable recovery process.
Can I still use my arm during treatment?
Yes, and in fact gentle use is encouraged. The evidence supports cold laser therapy alongside exercise — not instead of it. Avoiding use of the shoulder (while tempting when it is painful) can lead to further stiffening. The key is working within your comfortable range and gradually progressing as your mobility improves.
Why does my shoulder hurt more at night?
Night pain is one of the hallmark features of frozen shoulder. When lying down, the inflamed joint capsule is compressed, and the absence of daytime movement allows the capsule to stiffen further. Many people find that sleeping on the unaffected side with a pillow supporting the affected arm provides some relief.
How much does treatment cost at Adelaide Cold Laser?
Your first visit is $99, which includes a thorough assessment and treatment where clinically appropriate. Ongoing care options are discussed at your initial consultation. Most private health funds cover part of the cost under chiropractic extras. No lock-in plans. If you prepay for sessions you do not end up using, we refund them in full. The decision is always yours.
My GP said frozen shoulder just resolves on its own — why would I try treatment?
Frozen shoulder does have a natural history of eventual resolution, and your GP is correct about that. However, “eventual” can mean 1–3 years, and many people retain some residual restriction. The question is whether you want to wait — potentially in significant pain — or explore approaches that the evidence suggests may help manage symptoms and support recovery along the way. A Cochrane review found moderate evidence that LLLT combined with exercise improves outcomes compared to exercise alone. Individual responses vary.
I have already had a cortisone injection — can I still try cold laser?
Yes. Cortisone injections and photobiomodulation work through different mechanisms. Cortisone suppresses local inflammation (which can provide temporary relief), while PBM delivers light energy that may influence cellular processes and tissue remodelling. The two approaches are not mutually exclusive. Many people explore photobiomodulation when injection relief has been temporary or when they prefer to avoid repeat injections.
What makes frozen shoulder different from other shoulder conditions?
Frozen shoulder is distinct because it involves the joint capsule itself — the “sleeve” that surrounds the shoulder joint. Other conditions like rotator cuff injuries or impingement involve the muscles and tendons around the joint. In frozen shoulder, the capsule becomes inflamed, thickened and contracted, which progressively restricts movement in all directions. This is why stretching alone often feels ineffective — the capsule is physically preventing the movement.
Is there a link between diabetes and frozen shoulder?
Yes. Diabetes is one of the strongest risk factors for adhesive capsulitis. People with diabetes are 2–4 times more likely to develop frozen shoulder, and the condition tends to be more severe and longer-lasting. The exact mechanism is not fully understood, but it is thought to relate to the effects of elevated blood glucose on connective tissue. If you have diabetes and are developing shoulder stiffness, early assessment is recommended.
What device do you use and is it the same as what was used in the research?
We use the Multi-Radiance MR5 ACTIV PRO, an ARTG-listed (370913) super-pulsed laser device. It delivers multiple wavelengths including 905 nm super-pulsed laser, 875 nm infrared and 640 nm red light. The Cochrane review and other trials used various LLLT devices with wavelengths typically in the 780–904 nm range, which falls within the spectrum delivered by our device.
Will I get my full range of motion back?
Most people recover a significant proportion of their range of motion, though some retain mild restrictions that may not be noticeable in daily activities. The Cochrane review found that LLLT combined with exercise improved function outcomes that were maintained at 4 months. Recovery depends on multiple factors including the severity of capsular involvement, how long the condition has been present, and individual biology. Individual responses vary.
Can frozen shoulder affect both shoulders?
Approximately 6–17% of people with frozen shoulder will develop it in the other shoulder, though typically not at the same time. Having had frozen shoulder on one side is a risk factor for developing it on the other. The condition rarely recurs in the same shoulder.
Other Conditions We May Help With
Questions? We’re here to help.
Call us on (08) 8297 5277 or book online — no obligation.
Book a Consultation
$99 initial consultation includes full clinical assessment and first treatment session.
No lock-in plans. The decision is always yours.
(08) 8297 5277 • 528 Marion Road, Plympton Park SA 5038
Mon–Fri 7am–7pm • Sat 8am–12pm
References
- Page MJ et al. (2014). Electrotherapy modalities for adhesive capsulitis (frozen shoulder). Cochrane Database of Systematic Reviews, 2014(10):CD011324. PMID: 25271097
- Hawk C et al. (2017). Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions. JMPT, 40(5):293-319. PMID: 28554433
- Erdinc F et al. (2025). Effects of Low-Intensity ESWT and LLLT on Shoulder Adhesive Capsulitis: A Randomized Controlled Trial. Am J Phys Med Rehabil, 105(2):119-126. PMID: 40857136
About Adelaide Cold Laser
Practitioner: Dr Sam Johnson (Chiropractor), BSc(Chiro), MChiro — Macquarie University
Practice: Adelaide Cold Laser • 528 Marion Road, Plympton Park SA 5038
Phone: (08) 8297 5277 • Email: wecanhelp@stapletonchiropractic.com.au
Hours: Monday to Friday 7:00am – 7:00pm • Saturday 8:00am – 12:00pm
Pricing: $99 initial consultation • Private pay • No referral required
The information on this page is provided for general educational purposes and is not intended as medical advice. It describes findings from published peer-reviewed research and should not be interpreted as a guarantee or promise of any particular treatment outcome. Individual responses to photobiomodulation therapy vary. Not all patients will experience the results described in published studies.
Dr Sam Johnson (Chiropractor) will conduct a thorough clinical assessment before recommending any treatment approach. If you are experiencing shoulder pain, please consult a qualified healthcare practitioner for personalised advice.
All clinical claims on this page are supported by referenced peer-reviewed research. Study citations include PubMed identifiers (PMIDs) for independent verification.
Adelaide Cold Laser uses a clinical-grade super-pulsed laser device listed on the Australian Register of Therapeutic Goods (ARTG 370913).

