Frozen shoulder (adhesive capsulitis) can be very painful and often takes time to improve, even when
diabetes is well controlled. If exercises and painkillers have not provided relief, further options include guided physiotherapy under supervision, capsular stretching, or hydrodilatation (distension injection) which helps loosen the stiff joint capsule without surgery. In resistant cases, manipulation under anesthesia or arthroscopic release may be considered the choice depends on the stage and severity of stiffness. An orthopedic shoulder specialist can evaluate and suggest the most appropriate option.