”Frozen shoulder” is more specifically known as frozen shoulder, also known as constrictive capsulitis. Primary frozen shoulder is caused by the inflammation and further thickening and contracture of the shoulder capsule for unknown reasons, resulting in pain and limited movement of the shoulder joint. This is shown in the figure below. Patients often come to the hospital for treatment of shoulder pain and limited motion. Frozen shoulder often causes difficulties in dressing, personal hygiene, bathing and other daily activities, which seriously affects the quality of life. Note: The left side shows the joint capsule of a normal shoulder joint, while the right side shows an inflamed, thickened, contracted joint capsule. Patients with frozen shoulder often first consult orthopedics and TCM acupuncture/orthopedic injury. Orthopedics usually gives oral anti-inflammatory and pain relieving medications and joint cavity closure injections. These treatments can be effective in improving the patient’s pain symptoms, and Chinese acupuncture will also be useful for analgesia. However, the limited movement of the shoulder joint is not improved because it is not caused by pain alone, but more by the thickening and contracture of the joint capsule. Therefore, as you can imagine, there is no way to improve the mobility of the patient’s joint without treatment for the contracture of the joint capsule, and the patient needs to have the range of motion in the shoulder joint to meet the needs of daily living. The Department of Rehabilitation Medicine has unique exercise therapies and techniques that distinguish it from other disciplines such as orthopedics and Chinese medicine. Exercise therapy includes joint exercises and tension exercises. Manipulation is also different from Tui Na or massage in Chinese medicine, and is a Nordic manual therapy technique using the principles of mechanics – joint release. The most important aspect of the treatment of frozen shoulder is the use of appropriate joint exercises, distraction and joint release to open the adhesive joint capsule and improve joint mobility and function. Heat, short wave, ultrasound, and interferential electricity can be used prior to exercise therapy to improve the extension of the joint capsule, muscles, tendons, and ligaments. In addition, short-acting anti-inflammatory pain relievers can also be taken prior to exercise therapy. If your shoulder is sore after exercise, you can also apply local ice or take anti-inflammatory pain relievers. It is also worth mentioning the different levels of intensity of joint release techniques, which not only improve joint mobility but also provide pain relief. Pain-free treatment is the treatment philosophy followed by the Department of Rehabilitation Medicine. Joint release is a hands-on treatment technique performed by a rehabilitation physician or a rehabilitation therapist. Traction is applied to the shoulder joint in all directions to distract the contracted capsule, and the patient is encouraged to move the joint actively while the traction is applied to increase the active mobility of the joint. The effect of this treatment is immediate. Patients often experience varying degrees of improvement in shoulder joint mobility in all directions after treatment. The patient is often delighted with the improvement. The figure below shows a comparison of upper extremity anterior flexion before and after a single arthroplasty treatment in a patient with frozen shoulder. The following group of pictures shows the joint capsule in all directions of distraction and narrowing by arthrodesis. Of course, the rehabilitation of frozen shoulder is a long-term process, and the pain and limitation of movement will be treated accordingly in different stages. For early stage patients with mainly pain, the rehabilitation department not only gives patients oral anti-inflammatory and pain medications, but also has some analgesic treatments specific to the rehabilitation department, such as laser and interferential electricity. In the middle stage, we focus on joint loosening treatment for patients with limited mobility. In addition to coming to the rehabilitation department 2-3 times a week to receive professional rehabilitation treatment, home treatment is also important. In addition to coming to the rehabilitation department three times a week for professional rehabilitation, home treatment is also important. We will instruct patients to perform various self-relaxation, self-distraction and muscle training at home in the outpatient clinic. The vast majority of patients have self-healing characteristics of frozen shoulder, but the process is a long one, with an average duration of 2 years. The point of rehabilitation is to help the patient through the most difficult time (nighttime pain and severely limited movement) by reducing pain and improving function, improving the patient’s quality of life, and helping him/her through the most painful phase.