Many middle-aged and older adults suffer from painful shoulder disorders. Many middle-aged and older people report that they have pain and limited movement in the shoulder joint when they lift their hand over their head to get something high (getting a book from a bookshelf), behind their hand (such as tying a belt), or when they lift their shoulder or extend their hand laterally (such as picking up a ticket in a parking lot or drying clothes). Even when the shoulder joint does not move, it hurts, and resting does not make it any better, so I often wake up at night with pain. In recent years, more and more people in China have joined the ranks of physical exercise. However, due to excessive exercise, lack of sufficient warm-up and improper protection, the incidence of shoulder joint disease is getting younger and younger. Many people do not have enough knowledge about shoulder joint diseases, and call shoulder joint pain and restricted movement “frozen shoulder” in a general way. This part of the population either does not pay enough attention to it, and still carries out inappropriate exercises, such as carrying heavy objects, pulling the upper limb violently, thinking that it will be fine if they move around; or casually takes some painkillers, uses plasters to paste where it hurts, or carries out inappropriate massage. As a result, the shoulder joint disease is not treated regularly and effectively, and the condition is delayed or even further aggravated. So is shoulder joint pain all “frozen shoulder”? Are all shoulder joint diseases minor and do not require surgery? What kinds of shoulder disorders require a visit to the hospital or even surgery? First, let’s understand the shoulder joint. The shoulder joint is composed of six joints, which are divided into the acromioclavicular joint, glenohumeral joint, acromioclavicular joint, sternoclavicular joint, rostraloclavicular joint, and interscapular thoracic wall joint. Because the humeral head is large and spherical, the glenoid is very shallow and wraps around only 1/3 of the humeral head, and the capsule is thin and flaccid, the shoulder joint is the joint with the largest range of motion and most flexibility in the human body. However, the structural characteristics of the shoulder joint ensure that while it is flexible, it is less stable than other joints and is the most structurally unstable of the large joints in the body. The shoulder joint can be injured when we do not warm up sufficiently during exercise, when someone pulls the upper limb violently, when we lift heavy objects or when we hit the bladder directly. In addition to the degenerative changes in the shoulder joint of middle-aged and elderly people, the incidence of shoulder joint disease has increased dramatically due to the friction and impact of long-term daily life and work. There are at least seven or eight diseases that cause shoulder joint pain and impaired movement, and each disease is diagnosed and treated differently. Therefore, shoulder pain is not always “frozen shoulder”. The term “frozen shoulder” is a very general diagnosis. A large part of what some doctors and people now call “frozen shoulder” is frozen shoulder. The incidence of frozen shoulder is not high, and it occurs mostly in middle-aged and older people between the ages of 50 and 60, and is also known as the “fifty shoulder”. The main symptoms of frozen shoulder are progressive shoulder pain, stiffness, and limitation of both active (the patient moves the upper extremity by himself) and passive (others help move the upper extremity) activities, and the shoulder joint is limited in all directions. Patients are often unable to comb their hair, wash their faces, or put on clothes. Although frozen shoulder is a self-limiting disease, usually lasting one to two years, there are still many patients with pain and dysfunction lasting 7-10 years. In addition to conservative treatment measures such as pain relief, physiotherapy and hot compresses, pushing and releasing under anesthesia with functional exercises, or even arthroscopic release can greatly shorten the course of the disease and achieve satisfactory treatment results. In fact, rotator cuff injury is the most prevalent shoulder joint disease. The incidence of rotator cuff injury accounts for about 40% of shoulder joint diseases, and the incidence is higher in the elderly. The rotator cuff is composed of four muscles – supraspinatus, infraspinatus, subscapularis and teres minor – that wrap around the shoulder joint like a cuff. As we age, the tendons themselves degenerate with age, and the long-term wear and tear of daily life causes the rotator cuff to rupture. Patients often experience pain in the shoulder joint and weakness in the affected limb, often requiring the use of the good hand to lift the affected side. At this point, the patient needs to be examined by a medical professional, have X-rays and MRIs taken to confirm the diagnosis, and undergo arthroscopic repair as appropriate. Incorrect diagnosis and improper massage can even tear the rotator cuff further. The second shoulder disorder that has a high incidence is shoulder instability, and at the extreme, shoulder dislocation. This disease has a higher incidence in younger people. In many cases, trauma can lead to shoulder dislocation. The first time a shoulder dislocation occurs is called a primary dislocation. The first dislocation should be diagnosed and repositioned in the hospital as soon as possible. However, in some cases, the initial dislocation will result in a bone defect at the anterior border of the scapula and will require surgery. In some people, repeated dislocation of the shoulder joint after trauma, or even swatting mosquitoes or turning over in bed, can cause dislocation of the shoulder joint. Therefore, CT or MRI examinations should be completed after the first dislocation; for patients with recurrent dislocation, arthroscopic surgery is needed to repair the dislocation. Some patients with initial dislocations may even require arthroscopic surgery. Other common shoulder disorders include subacromial impingement syndrome, osteoarthritis of the shoulder, calcific rotator cuff, glenoid labrum injury, biceps longus tendon injury, and acromioclavicular dislocation. Therefore, shoulder joint disorders are not all “minor diseases” and should not be referred to as “frozen shoulder” in general. It is important to go to a regular hospital to have a professional medical examination by a professional doctor to confirm the diagnosis as soon as possible. The current shoulder arthroscopic surgery has the advantages of less trauma, faster recovery and fewer complications than traditional open surgery. The surgery itself is not scary, just a few holes in the shoulder can solve the shoulder joint pain.