Frozen shoulder is a common shoulder disorder, and it has a broad and narrow concept. Frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder. According to the American Academy of Shoulder and Elbow Surgeons, frozen shoulder is a type of adhesive capsulitis that causes stiffness of the glenohumeral joint. It is characterized by pain around the shoulder joint, reduced active and passive mobility of the shoulder joint in all directions, and no significant abnormalities on X-rays, CT or MRI, except for a decrease in the density of the local bone. The disease is more common in women than men, with more left than right shoulders, and some patients are bilateral. 50—70 years old middle-aged and elderly have the highest incidence. Among patients of the same age group, there are more patients suffering from diabetes, heart disease, and cervical spondylosis. The initial onset of frozen shoulder is characterized by pain and discomfort in one or several places on the patient’s side of the shoulder, which is more severe at night than during the day, and tends to increase when the shoulder is active. Some of the pains are dull, some are knife-like, and some are pins and needles or pulling pains, and most of the pains are widespread, mostly extending to the upper arm and the back of the shoulder. In severe cases, the hand cannot comb the hair, put on the clothes, lift the pants, or even hold the bowl and chopsticks. Some patients are in great pain. The clinical course is variable, but all patients terminate spontaneously. Some get better in a few months, others take years and are often unpredictable. The exact cause of frozen shoulder is not well understood and usually any cause that can cause limitation of arm or shoulder movement may develop into frozen shoulder. There are two types of frozen shoulder, primary and secondary, depending on the cause. The shoulder joint is the joint with the largest range of motion of any joint in the body. The joint capsule is relatively loose and the stability of the joint is mostly maintained by the strength of the muscles and ligaments around the joint. As we age, these muscles, tendons and ligaments undergo degenerative changes, and because the shoulder joint is so active in life, the surrounding soft tissues are often subjected to friction and extrusion from various sources, resulting in chronic strain and local aseptic inflammation, causing extensive adhesions to the joint capsule and other soft tissues, and gradually forming primary frozen shoulder. Frozen shoulder is often caused by trauma or tenosynovitis, bursitis, or may be caused by stroke. Often, it is difficult to determine the cause, but secondary frozen shoulder is a periarthritis that occurs secondary to other conditions. Most commonly, it is secondary to acute trauma to the shoulder or upper extremity, such as clavicle fracture, scapula fracture, proximal humerus fracture, etc.; rotator cuff rupture, ligament rupture, etc. all require prolonged immobilization of the shoulder joint. Long-term immobilization of the shoulder joint can cause adhesions and contractures of the shoulder capsule, resulting in periarthritis. In addition, cervical spondylosis and low back disorders can also affect the shoulder joint movement and lead to secondary frozen shoulder. There is no definitive answer to the pathological mechanism of frozen shoulder, and many medical doctors have numerous arguments and have obtained different results from different perspectives. Many scholars have demonstrated that whatever the cause of soft tissue non-specific inflammation in the shoulder, the joint capsule and ligaments eventually lose their elasticity, the joint capsule becomes thick and contracted, and the volume of the joint cavity can be significantly reduced from the normal 20-30 ml, thus limiting shoulder joint movement; therefore, local aseptic inflammation and reduction of joint cavity volume are two important features of frozen shoulder. According to the evolution of frozen shoulder, it is clinically agreed that it can be divided into three phases according to its pathology: the coagulation phase, the freezing phase and the thawing phase. The freezing phase: this is the early stage, which is characterized by gradually increasing shoulder pain, mildly restricted shoulder mobility, increased pain during joint activities, and widespread pressure pain; the freezing phase: this is characterized by persistent pain, severe pain at night, and severely restricted shoulder movement in all directions; the thawing phase: this is when the local pain is gradually relieved and the function of the shoulder joint is gradually restored. Of course, not all shoulder pain and dysfunction is frozen shoulder. If there is trauma, we should exclude shoulder fracture and dislocation; if there is upper limb weakness and numbness, we should beware of nerve injury; if there is cervical spondylosis, we should also treat cervical spondylosis. In Chinese medicine, this disease belongs to the category of paralysis and shoulder paralysis. In people in their fifties, the liver and kidneys are declining, the blood is insufficient, the tendons and veins are not nourished, coupled with traumatic strain and injury, wind, cold and damp invasion leads to stagnation of blood and qi, phlegm and dampness coagulation shoulder, meridians closed and blocked. Insufficient qi and blood, blood does not glory tendons as its internal cause, trauma and strain as its external cause, belong to the original deficiency of the table real disease. The treatment of frozen shoulder should be based on comprehensive conservative treatment. Generally speaking, if the diagnosis is timely and the treatment is appropriate, the course of the disease can be shortened and the motor function can be restored early. There are many specific treatment methods, including tui na, manipulation and release, acupuncture, internal and external medication, physical therapy, surgery, etc. The principle of treatment for frozen shoulder should be to take appropriate measures for different periods of frozen shoulder or the severity of its symptoms. Based on the academic experience of Shih’s injury and Wang’s injury, combined with modern medical methods, Professor Shi Qi from the Department of Orthopedic Injury of Longhua Hospital has summarized a set of staged prevention and treatment plan for frozen shoulder after years of clinical exploration. For patients in the early stage of the disease with mild pain, pain that is only obvious when moving and mildly limited functional activities, they are suffering from Qi and blood deficiency and evil attacking the meridians, so they should take the internal formula of benefitting Qi and activating blood to relieve coagulation (Shi’s empirical formula: roasted astragalus, angelica, red and white peony, Chuanxiong, raw earth, Chai Hu, fried burdock, Ge Gen, Gui Zhi, chicken blood vine, roasted ground turtle, roasted licorice), apply homemade ointment externally and cooperate with physical therapy; while for patients with pain For patients whose pain is obvious and affects their sleep, and whose shoulder joint activities have been obviously affected, hydraulic expansion + manual release is added on top of the above method, that is, a certain amount of liquid is injected into the joint cavity to expand the shoulder joint capsule and relieve pain, and then the joint is released by manual release immediately, once a week, usually 2-3 times, to achieve obvious results. For those patients with severe shoulder joints that have been completely adhered to by hydraulic expansion, we use closed shoulder joint release under anesthesia + TV X-ray machine, together with the internal administration of the formula of Beneficial Qi, Relieving Stasis and Dispersing Nodules (Shi’s formula: roasted astragalus, raw pu huang, wuling fat, angelica, curcuma longa, roasted silkworm, made south star). (Shi’s formula: roasted astragalus, raw pu huang, wuling lily, angelica, curcuma, roasted ginseng, made nansheng, roasted frankincense, roasted ground turtle, fried heliotrope shell, qiang wu, gentiana, roasted licorice), together with external application of medicinal residues. It is very important for patients with frozen shoulder to exercise their own functions. While tui-na massage and manual release are passive joint activities, voluntary functional exercise allows for better continuation of the doctor’s treatment and also prevents further adhesions due to excessive release of the injury. Based on the Wang’s Injury Medicine Twenty Positions for Dispelling Diseases and Prolonging Life, we have created a set of simple health care exercises for frozen shoulder to match our staged ladder treatment. 1. Elbow pushing: bend over slightly, lean forward, hold the forearm wrist of the affected limb with the healthy hand, bend the elbow joint 90 degrees and make a pushing movement, clockwise and counterclockwise 12 times each; 2. Bend over and transport the shoulder: bend over, lean forward, droop the affected limb, or hold a 1-2 pound weight in the affected hand to play a traction role, row left, right, front and back 12 times each, then row from small to large, clockwise and counterclockwise 12 times each. . 3. Scorpion climbing wall: face the wall, lift the affected shoulder forward, and climb upwards alternately with the 2nd-5th fingers of the affected hand like a scorpion’s foot, until the shoulder pain is unbearable, 12-36 times from the bottom upwards; then turn sideways to the wall, with the affected shoulder abducted and the fingers climbing in the same way as before. 4.Reverse pulling shoulder: pull both hands backwards in the waist, pull the affected limb with the good hand, pull left and right, 12-36 times; if you can’t pull, you can use a towel or stick to transition; 5.Shake hands to pat shoulder: shake hands, left hand to pat right shoulder, right hand to pat waist; right hand to pat left shoulder, left hand to pat waist, 12-36 times. There are fitness equipment, you can choose some of them to help exercise according to the actual situation, and grasp the principle of making the shoulder joints carry all directions of activity. It can be said that half of the treatment for frozen shoulder depends on the doctor and half on yourself. At the same time, to consolidate the effect of treatment, during the late thawing period or recovery period, you should often take internal medicine to benefit qi, nourish blood and relieve tendons (Shi’s formula: roasted astragalus, dang ginseng, angelica, white peony, chuanxiong, rehmannia, chai hu, deer’s-eye grass, Xian Ling Spleen, Bai Xi Li, Xiang Cyperus, chicken blood vine, roasted licorice), and also with the external application of medicinal residue. The best treatment is prevention. The most ideal and simple way to prevent frozen shoulder is to insist on physical exercise, such as playing taijiquan, doing exercises, etc. Pay attention to keeping your shoulder warm, don’t sleep with your shoulder exposed in summer, don’t blow fans and air conditioners on your shoulder; wear shoulder pads in winter; don’t sleep in damp places to prevent wind, cold and dampness; prevent chronic strain on your shoulder, don’t suddenly do strong labor or unload heavy objects with both hands without preparation. Do not do sudden strong work or lift heavy objects without preparation to prevent shoulder sprain.