Understanding “frozen shoulder”

  Frozen shoulder is a familiar disease and a common disease in our pain clinic. It occurs mostly in people around 50 years old, especially in people who work in long-term ambulatory jobs where the muscles and ligaments of the shoulder are under long-term tension, and the soft tissues of the muscles and tendons around the shoulder produce chronic inflammation leading to stiff joints and restricted movement, as if they are frozen, so it is also called “frozen shoulder “, “shoulder coagulation”.  The symptoms of frozen shoulder are mainly pain and limited movement of the shoulder joint. The initial onset of frozen shoulder manifests as shoulder pain, which is persistent, especially at night when the pain worsens. Patients are afraid to lie on the affected side, have difficulty sleeping, and can sometimes wake up from the pain in their dreams. Patients always consciously protect the affected limb from being touched by people around them during daytime activities, fearing that touching will cause severe pain. Shoulder joint movement is limited, mainly in abduction, supination and external rotation. Patients cannot comb their hair, wash their faces, carry their hands, or even put on or take off their clothes. If the duration of frozen shoulder is long, the local muscles of the shoulder and arm will also atrophy, causing great pain to the patient.  Some patients with frozen shoulder will heal on their own without treatment, but for patients with long duration of the disease and severe pain, timely treatment is very important. Timely treatment not only relieves the symptoms but also helps to restore the function of the shoulder joint as soon as possible. Currently, there are many treatments for frozen shoulder in the pain department, such as physical therapy, medication, and injection therapy. Among them, injection therapy has a rapid onset of action, and the pain can be relieved quickly, which has an “immediate effect”. The combined application of multiple therapies is more effective. Functional exercise should not be neglected in the treatment of frozen shoulder. On the basis of not causing severe pain, daily active exercise can prevent shoulder muscle atrophy and the formation of frozen shoulder, so as not to leave the shoulder joint dysfunction. For patients whose shoulder joint movement has been restricted, shoulder arthrolysis can be performed under brachial plexus anesthesia to restore the motor function of the shoulder joint. Active movement of the shoulder joint is not only an important method of treating frozen shoulder but also an effective method of preventing it. For people around 50 years old and those who work long hours, they should pay attention to active exercise of the shoulder joint every day to avoid the occurrence of “frozen shoulder”.