The first thing patients who come to the clinic with shoulder pain often say is “Doctor, do I have frozen shoulder?” This is especially true for patients who can’t sleep at night.
Causes of frozen shoulder
It is mainly caused by the degeneration of soft tissues and the weakened ability to withstand various external forces; chronic injury caused by long-term over-activity, poor posture, etc. Some upper limb fractures have been braked for a longer period of time and the periapical tissues have atrophied and adhered to each other; other scholars believe that it is related to emotional instability, mental depression and poor nutrition.
Diagnostic methods of frozen shoulder
1. Shoulder pain: Initially, the shoulder pain is paroxysmal, most of them are chronic, later the pain gradually increases or dull pain, or knife-like pain, and it is persistent. If the pain is caused by cold, it is particularly sensitive to climate change.
As the disease progresses, the adhesions of the joint capsule and the soft tissues around the shoulder caused by long-term disuse, the muscle strength gradually decreases, and the rostro-humeral ligament is fixed in a shortened internal rotation position, so the active and passive activities of the shoulder joint in all directions are limited, especially combing, dressing, washing, forking and other movements. In severe cases, the function of the elbow joint can be affected. When flexing the elbow, the hand cannot touch the ipsilateral shoulder, especially when the arm is extended backwards, the elbow flexion cannot be completed.
3. Fear of cold: Patients are afraid of cold shoulder, many of them use cotton pads to wrap their shoulders all year round, and even in summer, they dare not blow the wind on their shoulders.
4.Pressure pain: Most patients can feel obvious pressure points around the shoulder joint, mostly at the long head biceps tendon groove, subacromial bursa, rostral process, supraspinatus attachment point, etc.
5. Muscle spasm and atrophy: Spasm of the deltoid, supraspinatus and other muscles around the shoulder may occur in the early stage, and disuse muscle atrophy may occur in the late stage, resulting in typical symptoms such as protrusion of the shoulder peak, inconvenience in lifting, and inability to extend backwards.
Examination of frozen shoulder
Experienced physicians will treat the symptoms according to their experience. Radiographs are routinely needed to assess and rule out any bone changes.
MRI of the shoulder joint can determine whether the signal of the structures around the shoulder joint is normal and whether there is inflammation, which can be an effective method to determine the location of the lesion and differential diagnosis. It can be used to rule out simple supraspinatus tendon injuries, rotator cuff tears, biceps longus tendonitis, and other diseases. However, it is more expensive.
Characteristics of frozen shoulder
1. The function of shoulder joint activity is limited and is getting worse, gradually relieving after reaching a certain level, until finally completely recovered. Generally, it can heal itself in about 12-24 months, but 60% cannot return to normal function. This painful process is only clear to the patient. So once it develops, it still needs to be treated actively.
2. Rotator cuff injury, acromion impingement syndrome, periapical pain after permanent pacemaker, dorsal scapular nerve entrapment syndrome, fracture of the external end of the clavicle, after the use of clavicular sulcus plate, inflammation and tumor in the thoracic cavity, cervical spondylosis, shoulder entrapment pain occurring from heart, lung and biliary tract diseases, etc. You can’t be careless, it’s not that shoulder pain is frozen shoulder, check what experience on the Internet, take oral painkillers, aggravate the condition and delay the treatment.
Treatment of frozen shoulder
Depending on the degree of lesion, different methods are adopted.
1. In the early stage, the patient should be encouraged to tolerate the pain and perform independent exercise. Acute pain can be closed for painful points. Generally, it can relieve the symptoms and improve the function.
2.Surgical treatment can be considered for a very small number of patients whose symptoms do not improve after the above-mentioned comprehensive treatment, and who have aggravated the disease for a long time.
3, Chinese medicine has a unique side to the treatment of this disease that old age, kidney energy gradually decline, blood loss, and external wind and cold evil, so that the blood and Qi stagnation, poor circulation, blood does not camp tendons. It is often divided into: external wind and cold, cold and damp stagnation, qi stagnation and blood stasis, liver and kidney deficiency, etc. Chinese acupuncture (especially fire acupuncture), small acupuncture needles, massage, and gong practice are all worth using.
Home health care methods for frozen shoulder
Note: Activities should be performed within the pain-free range, because pain can reflexively cause or aggravate muscle spasm, thus affecting functional recovery. Each activity should not cause an increase in pain. The opposite suggests over-activity or a new injury, it is appropriate to adjust the amount of exercise at any time.
1, finger wall climbing therapy: the patient touches the wall in front of the hand, from low to high, using the index finger and middle finger alternately slowly climb up, climb to a height they can tolerate, make a mark, the next time to strive to climb higher. Climb higher and higher for 15-20 minutes, 2-3 times a day, and it will help you recover from frozen shoulder. Be careful not to bend your body sideways when climbing the wall.
2.Towel pulling therapy: Take a long towel, pull one end with each hand, put it behind you, one hand on top, one hand on the bottom, and tug it like a bath. At the beginning of the activity, the patient may have some restrictions, but do not rush, the action slowly from small to large, and feel better and better. If you keep doing this several times a day, the condition of frozen shoulder will gradually improve.
3.Drawing circles against the wall: Patients face the wall, straighten their arms and symbolically make circles against the wall. Repeat this action often, it will help a lot in the recovery of frozen shoulder.