Research on frozen shoulder has identified different pathological changes from different perspectives and has proposed numerous etiological theories. “Frozen shoulder” is a syndrome of shoulder pain and motor dysfunction, and is not a single cause of disease. The broad definition of frozen shoulder includes subacromial bursitis, supraspinatus tendonitis, rotator cuff tears, biceps longus tenosynovitis, rostral synovitis, frozen shoulder, acromioclavicular joint lesions, and many other disorders. The term “frozen shoulder” in the narrow sense is used as a synonym for “frozen shoulder” or “fifty shoulder” in China. The pathogenesis of the disease is divided into three phases: 1. Acute phase: Also known as the freezing phase. The onset of the disease is acute, with severe pain, muscle spasms and limited joint movement. The pain increases at night and it is difficult to sleep. The pressure pain is widespread, and there is no abnormality in X-ray examination. 2. Chronic phase: also known as the freezing phase. At this time, the pain is relatively relieved. The joint function is limited by the muscle spasm in the acute phase to the joint contracture dysfunction. The soft tissues around the joint are “frozen”, and X-ray examination may occasionally reveal a sparse, cystic change in the shoulder crest and greater tuberosity. Arthroscopy: Adhesions in the joint cavity and reduction in joint volume,
Fibrous strips and floating debris can be seen in the cavity. 3. Functional recovery period: Inflammation is gradually absorbed, blood supply is normalized, synovial fluid secretion is gradually restored, adhesions are absorbed, joint volume is gradually restored to normal, and most patients can restore normal or near normal shoulder function. Muscle atrophy requires a longer period of exercise to return to normal. Treatment options and principles: 1. Non-surgical treatment: Acute antispasmodic and analgesic. In the freezing phase, the treatment principle is to do proper functional exercise under the condition of pain relief to prevent the joint contracture from aggravating. 2.Manipulation and release: It is suitable for patients with shoulder contracture who have no pain or whose pain has been basically relieved. It is performed under general anesthesia: posterior extension release in the sagittal plane, abduction and adduction release in the coronal plane, and finally, axial release of internal and external rotation.
Manual release must be done slowly, avoid violence, and must be done in order of sagittal plane, coronal plane and axial release. 3.Surgical treatment: the indications are freezing stage patients, with severe joint contracture, by non-surgical treatment is not effective, can be surgically stripped adhesions.