I. What is frozen shoulder?
”Frozen shoulder” is a common disease among the general public, and any pain and limited movement in the shoulder joint area is blamed on “frozen shoulder”. As research into frozen shoulder has progressed, it has been discovered that there are many diseases that cause pain and limited movement in the shoulder joint, including: calcific tendonitis, adhesive subacromial bursitis, biceps tendonitis, supraspinatus tendonitis, impingement syndrome, rotator cuff injury tears, shoulder instability, etc. Strictly speaking, these diseases are no longer called frozen shoulder. Strictly speaking, these diseases are no longer called frozen shoulder. The true frozen shoulder refers to adhesive capsulitis, the cause of which is unknown, and its main clinical manifestation is pain and limitation of shoulder joint movement.
II. Is all shoulder pain caused by frozen shoulder?
In outpatient clinics, we often refer to shoulder pain and impaired movement as frozen shoulder. Many of these patients are indeed suffering from frozen shoulder, but many others are misdiagnosed. Shoulder pain can be caused by the shoulder joint itself.
1. Inflammation of the shoulder joint, including inflammation with bacterial infection and inflammation without bacterial infection. Inflammation caused by bacterial infection like tuberculosis, streptococcus, staphylococcus and other infections. There are more aseptic inflammatory diseases, such as rheumatoid arthritis, osteoarthritis, allergic arthritis, gouty arthritis, ankylosing spondylitis, etc.
2.Shoulder joint injury, the most common is soft tissue injury inside and outside the shoulder joint, such as: ligament, muscle, joint glenoid lip, cartilage injury, fracture, etc.
3.Shoulder joint tumor, including benign tumor, malignant tumor and metastatic tumor.
Sometimes shoulder joint pain is not always due to the shoulder joint itself. Disorders of the neck, such as the most common cervical spondylosis, can cause shoulder pain. Heart conditions such as myocardial infarction and angina can sometimes radiate to the left shoulder and be misdiagnosed as frozen shoulder. Gallbladder disease, gallstones, and cholecystitis pain radiating to the right shoulder can also be mistaken for frozen shoulder. In conclusion, there are many diseases that can cause shoulder pain. For shoulder pain, you should carefully diagnose, clarify the cause and treat the symptoms.
C. What is frozen shoulder?
The real meaning of frozen shoulder is known as “frozen shoulder”, which is commonly known as “fifty shoulder”. It is also known as frozen shoulder and adhesive capsulitis. In Chinese medicine, this disease belongs to the scope of “paralysis” and is also known as “frozen shoulder” and “shoulder condensation”. According to domestic data, 50-60% of people over the age of 45 in China suffer from the disease to varying degrees, with the incidence on the left side being higher than that on the right side. Frozen shoulder is a self-limiting disease of unknown etiology. Its etiology is not well understood, but some studies suggest that it is related to autoimmune diseases and infections. Its pathology is characterized by severe adhesions of the joint capsule tissue within the shoulder joint. The symptoms are progressive limitation of shoulder movement without cause, especially limitation of external rotation, and pain in the shoulder joint, which can affect sleep in severe cases. The pain and limitation of movement reach their peak at 3-6 months after the onset of the disease, after which the symptoms gradually resolve, and if left untreated, most patients’ symptoms resolve completely about 1 year after the onset of the disease, but there may be varying degrees of shoulder dysfunction.
4. How is frozen shoulder diagnosed?
The diagnosis of frozen shoulder is a diagnosis of exclusion, which means that all diseases that may cause shoulder pain and limited movement, such as rotator cuff injury, post-traumatic adhesions and osteoarthritis of the shoulder joint, should be excluded before a diagnosis can be made. Shoulder arthrography can clarify the diagnosis, and a decrease in shoulder joint volume can be seen during the imaging. Arthroscopy can establish the diagnosis early. In early stages of frozen shoulder, the synovial membrane of the joint cavity is congested, the villi are hypertrophied and proliferate, filling the joint space and narrowing the joint cavity, reducing the volume, and the intra-articular segment of the long head of the biceps is covered with vascular opacities. In the chronic phase, fibrosis of the joint capsule, thickening, adhesions of the joint cavity, atresia of the subacromial wall of the shoulder glenoid, and a significant decrease in joint volume can be seen. In addition, shoulder arthroscopy can also rule out or diagnose other shoulder diseases, such as calcific tendonitis, adhesive subacromial bursitis, biceps tendonitis, supraspinatus tendonitis, impingement syndrome, rotator cuff injury tear, shoulder instability, etc. Biopsies can also be removed for pathological examination. Although arthroscopy has a high diagnostic value for shoulder joint diseases, it is an invasive and invasive diagnostic method and has certain limitations.
V. What are the factors associated with frozen shoulder?
1, local cold and wind, such as living in a humid place, stroke and rain, sleeping and sleeping with exposed shoulder, etc.
2.Trauma or history of local external fixation.
Frozen shoulder and emotions are mutually dependent. Frozen shoulder causes significant pain in the shoulder, which can seriously affect life, work and sleep, thus causing significant anxiety and depression in patients.
4. Gender. The proportion of women is higher, accounting for about 55%.
5, endocrine. Women’s estrogen levels drop significantly during menopause, and endocrine disorders can lead to frozen shoulder. The incidence of frozen shoulder is higher in diabetic patients, in which the incidence of frozen shoulder is higher in type I diabetic patients, and the proportion of type I diabetic patients with bilateral frozen shoulder is significantly higher than normal. Freezing shoulder is associated with thyroid disease. Patients with hyperthyroidism and hypothyroidism are prone to freezing shoulder, and the specific effects and pathogenesis are not clear.
6. Hemiplegia.
7. The incidence of frozen shoulder is more common in brain workers than in manual workers. Long-term ambulatory workers, computer workers, teachers, housewives, accountants, long-term handicraft workers, office workers, the above-mentioned occupations have been considered as one of the high-incidence occupational diseases. With the progress of modern life, the improvement of people’s working environment, the increase in competitive pressure, the impact of extended ambulatory time, the increasing number of patients with this modern civilization disease, and there is a significant underage, many of them are sitting in the office of young white-collar workers.
8, physical weakness: a long illness causes physical weakness, the shoulder joint movement is reduced, the shoulder joint adhesion and produce this disease.
6. Is frozen shoulder related to cervical spondylosis?
Frozen shoulder is closely related to cervical spondylosis. The main clinical symptom of some cervical spondylosis is shoulder pain, and cervical spondylosis can be combined with frozen shoulder. Therefore, the diagnosis of these two diseases needs to be especially careful, and it must be clarified whether it is simple cervical spondylosis, simple frozen shoulder, or cervical spondylosis combined with frozen shoulder. The location, duration, mode and extent of pain in cervical spondylosis is different from that of frozen shoulder, and the course and progression of the disease are different, as is the treatment. The pain of frozen shoulder is a persistent dull ache, which often manifests as soreness and swelling, while the pain of cervical spondylosis is mostly numbness and pain radiating to the upper extremities and hands. In addition, there is a difference in the location of the pain between the two. The pain of frozen shoulder is mostly located in the shoulder, while the pain of cervical spondylosis is mainly in the neck. Frozen shoulder can be secondary to cervical spondylosis. Cervical spondylosis is caused by the compression of the nerves through the cervical spine osteophytes, causing symptoms such as radiating pain, numbness and impaired movement in the shoulder or upper extremity, thus cervical spondylosis can lead to joint capsule adhesions and contractures, and can also lead to a decrease in coordination of shoulder joint activities, thus making it easy for frozen shoulder to occur.
VII. What is secondary frozen shoulder?
Secondary frozen shoulder is a periarthritis of the shoulder joint that occurs secondary to other diseases. The most common form is frozen shoulder secondary to acute trauma to the shoulder or upper extremity. Trauma to the shoulder, including shoulder fractures and ligament ruptures, requires prolonged immobilization of the shoulder joint. Upper extremity trauma, especially humeral fractures, also require prolonged immobilization of the shoulder joint. Prolonged immobilization of the shoulder joint can cause adhesions and contractures of the shoulder capsule, resulting in periarthritis. Others are: biceps long head tenosynovitis, rotator cuff injury, supraspinatus tendonitis, dorsal shoulder fasciitis, heart disease, and fixation of the shoulder joint after upper extremity surgery, which can cause shoulder joint adhesions. The pain associated with tuberculosis, gastrointestinal dysfunction or facial disorders can also spread to the tissues around the shoulder joint and cause frozen shoulder. In addition, cervical spondylosis and low back disorders can also affect the shoulder joint activities and lead to secondary frozen shoulder.
VIII. Is frozen shoulder hereditary?
The genetic predisposition of frozen shoulder is not obvious, and most surveys have not found a significant correlation between frozen shoulder and genetics.
ix. Is frozen shoulder contagious?
Frozen shoulder is a chronic aseptic inflammatory disease and is therefore not contagious. However, because frozen shoulder is related to environmental factors, people who live together can develop frozen shoulder at the same time or in succession.
X. What are the characteristics of the pain of frozen shoulder:
1. The pain is dull or cut-like, not only limited to the shoulder, but also radiates to the elbow and wrist, and can also radiate to the scapula. Once the pain occurs outside of the shoulder, this can cause difficulties in differential diagnosis. For example, involvement of the pectoralis major muscle can be misdiagnosed as heart disease, and involvement of the trapezius muscle can be misdiagnosed as cervical spondylosis.
Most patients often complain of waking up in the second half of the night with pain and cannot sleep, especially when lying on the affected side.
3.It is accompanied by muscle spasm.
4. The pain often worsens after climate change or exertion.
5. Fear of cold, many patients use cotton pads to wrap their shoulders all year round, even in the summer, the shoulder does not dare to blow.
11. Is it frozen shoulder when there is a ringing sound when the shoulder joint moves?
This occurs when the tendon hits the ligament or bone, or it may be the tendon sliding on the bone surface. Generally speaking, people with frozen shoulder do not have a ringing sound when they move around, but other shoulder disorders do. This sound can occur in other shoulder disorders such as supraspinatus tendinitis, biceps tendinitis, calcific tendinitis, subacromial bursitis, and subacromial impingement syndrome.