The prevalence of shoulder pain in the elderly is very high, accounting for about 30% of outpatients with joint pain, the most common shoulder pain is commonly known as “frozen shoulder”, “fifty shoulder”. Even some orthopedic surgeons often diagnose shoulder pain as frozen shoulder. Not all shoulder pain in the elderly is frozen shoulder, so some shoulder doctors call “frozen shoulder” a garbage can. This garbage can carries dozens of injuries and diseases that cause shoulder pain. The common causes of shoulder pain in the elderly are generally the following: rotator cuff injury, subacromial impingement syndrome, frozen shoulder, and long biceps tendonitis. Rotator cuff injury: The rotator cuff is the protective tissue around the shoulder joint, which can be torn by acute strain, fall, impact or long-term chronic strain. The main manifestations are: 1. Recurrent or continuous shoulder pain, especially when lifting and posterior extension, increased pain and weakness; 2. Shoulder off aggravated or triggered by a certain reason. Forty percent of rotator cuff injuries have tears in the rotator cuff that increase in size, and 80 percent of these will be symptomatic due to an increased tear. Over time, many people tend to accept the symptoms of persistent pain, weakness of the limb and limited motion of the joint, thus forgoing further treatment and losing the opportunity to improve pain and function. The quality of life is much reduced, such as large rotator cuff tears with heavy nighttime pain, which seriously affects the patient’s sleep and leads to other disorders. And with the further development of the disease leads to advanced shoulder stiffness and degeneration of the articular cartilage leading to arthritis. Therefore, once the diagnosis is clear, we should intervene surgically. Subacromial impingement syndrome: It is one of the most common causes of shoulder pain in middle-aged and elderly people, even more than the traditionally considered “frozen shoulder”. The pathogenesis is that there are several gaps in the outer upper part of the shoulder joint, and no contact occurs between the tissues surrounding the gaps during normal motion. When the gap is narrowed in a pathological state, the bursa and supraspinatus tendon are damaged, resulting in shoulder pain, which can be characterized by waking up at night with pain and difficulty in identifying the location of the pain. Patients who develop this disorder often need professional medical guidance for rehabilitation and treatment. Otherwise, long-term impingement can lead to further damage such as rotator cuff injury, resulting in weakened muscles and increased pain, and if necessary, minimally invasive arthroscopic capsuloplasty. Frozen shoulder: It is also known as “fifty shoulder”, and it occurs in middle-aged and elderly people. In the past, the pain and limitation of movement in the shoulder joint were often classified as frozen shoulder. In the past, the pain and limited movement in the shoulder joint were often classified as frozen shoulder. With the gradual research on frozen shoulder, the mystery of frozen shoulder has been slowly uncovered. The causes of frozen shoulder are: 1) chronic diseases such as microtrauma, inflammation and diabetes; 2) autoimmune diseases; 3) cervical spondylosis, hyperthyroidism and ischemic heart disease, which seem to have some connection with the development of frozen shoulder. In clinical practice, there are three main periods of frozen shoulder: pain, stiffness and remission. The disease tends to be self-limiting within 1.5 to 2 years, but if not treated regularly, it may lead to shoulder stiffness. At present, the main research advances and theories on the shoulder joint are as follows: 1. “Frozen shoulder” is a disease similar to “Dupuytren’s contracture”, which is mainly manifested by contracture of the diseased tissue and proliferation of fibroblasts found in the joint capsule biopsy. 2. Frozen shoulder is a “reflex sympathetic dystrophy” disease, and it has been found that patients with frozen shoulder often have reduced bone mass in the upper humerus. The reduction in bone volume is accompanied by unexplained pain, which is consistent with the definition of “reflex sympathetic dystrophy”. 3. Frozen shoulder is characterized by varying degrees of thickening, fibrosis and adhesions of the rostro-humeral ligament. In the early stages of frozen shoulder, the inflammation of the “rostro-humeral ligament” or “sub rostral bursa” can be treated; in the later stages, the contracted “rostro-humeral ligament” can be released through minimally invasive arthroscopic surgery. “The joint mobility can be relieved by minimally invasive arthroscopic surgery. Long biceps tendonitis: The long biceps tendon is the tendon that connects the biceps to the scapula and serves to flex the elbow, rotate the forearm back, press down on the humeral head, and flex the shoulder joint. Biceps long tendonitis is is one of the most common causes of shoulder pain, especially in older adults and athletes with more upper extremity applications (swimming, rowing, throwing, golf and weightlifting, etc.). The main etiologies are: 1. The long biceps tendon passes through the biceps tendon groove between the subscapularis and supraspinatus muscles under a fibrous sheath envelope. In the presence of rotator cuff disease or disease of adjacent structures, inflammation can involve the long biceps tendon, leading to degeneration and wear; 2. Inflammation, edema, micro-tears and degeneration due to subacromial impingement; 3. Caused by acute strains. For such patients, treatment with non-steroidal anti-inflammatory drugs can effectively relieve pain, often in combination with physical therapy and plyometric exercises. Local injection of anesthetics and hormonal drugs to relieve pain and inflammatory reactions is also a very effective treatment. It is worth noting that some patients have the possibility of rupture of the long head of biceps tendon after local closure, so it is required that a shoulder surgeon or sports medicine physician It is worth noting that some patients have the possibility of developing a rupture of the long head of the biceps tendon after local closure, so it is required that the injection be completed by a shoulder surgeon or sports medicine doctor in order to prevent infection and poor results and avoid complications.