Frozen shoulder is a chronic aseptic inflammation of the joint capsule and soft tissues surrounding the shoulder joint caused by injury and degeneration of the muscles, ligaments, tendons, bursa, and joint capsule, etc. It is common in patients around 50 years old, so it is also known as “fifty shoulder”. “It is a chronic aseptic inflammation of the joint capsule and soft tissues around the joint caused by soft tissue injury and degeneration. It is also called “frozen shoulder” or “shoulder coagulation” because after the disease, the inflammation causes adhesions inside and outside the joint, which affects the movement of the shoulder joint and seems to be frozen or coagulated. The onset of the disease is usually slow, but a few patients may have an acute onset. The duration of the disease is usually less than 1 year, but in some cases it can be 1-2 years. It is usually caused by chronic strain and degeneration of the shoulder joint, cold and other factors, and in some patients it is secondary to cervical spondylosis, rheumatoid arthritis, trauma to the shoulder joint or prolonged external fixation. Clinical manifestations Usually the onset of the disease is slow and can be triggered by strain, cold, etc. At the beginning, the main manifestation is pain in the biceps tendon, infraspinatus tendon or subacromial bursa, which is aggravated by activity and can be relieved by rest or hot compresses. As the disease progresses, the pain may extend to the neck, scapula and upper arm, but usually does not involve the forearm and hand. The pain may be moderate to severe, and may be worse at night, even waking up in pain. The pain is aggravated when the shoulder joint is moved, resulting in a decrease in shoulder joint movement. Extensive adhesions of the soft tissues around the shoulder limit the joint movement, such as abduction, posterior extension, supination, external rotation and internal rotation. If the disease lasts for a long time, it may cause atrophy of the deltoid, biceps, triceps and other muscles around the shoulder and osteoporosis of the humerus. Diagnosis 1. Peri-shoulder pain. Chronic onset, long duration, peri-shoulder pain, aggravated by activity, and pressure pain in the rostral process, inter-nodal groove, subacromial and infraspinatus tendons. 2. Restriction of shoulder joint movement. The pain is aggravated when the shoulder joint is moved, and the active and passive range of motion is limited, especially in abduction, posterior extension and supination. 3. There is no peri-articular redness, swelling, fever, numbness and weakness of the distal elbow joint. Auxiliary examinations: positive and oblique x-ray of shoulder joint; MRI scan of shoulder joint; blood count, ESR, CRP, etc. Exclude joint dislocation, occupying lesions, and tuberculosis, septic arthritis, etc. Treatment principle: anti-inflammatory and analgesic, restore joint function. Treatment 1. Give anti-inflammatory and analgesic drugs and blood-activating and analgesic drugs or topical ointment treatment. Apply local heat. Strengthen functional exercise. 2.If the pain is severe, periacetabular block and ozone injection are feasible. Strict adherence to the principle of aseptic operation is required. Patients with low immunity (e.g. diabetes, old and weak) should take oral antibiotics for 3 days after periacetabular block to prevent infection. 3. Shoulder joint adhesions should be performed under brachial plexus nerve block anesthesia or intravenous general anesthesia for shoulder joint manipulation and release. After the operation, strengthen the functional exercise of the affected shoulder.