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Abstract: A 50-year-old patient, Auntie Li, came to our hospital with “shoulder joint pain with limitation of movement”. After an MRI of the shoulder joint, she was diagnosed with shoulder joint lesion. The patient was recommended to be hospitalized for comprehensive conservative treatment. After massage and relaxation, ice pack cold compress and rehabilitation, the patient’s shoulder pain was relieved and the range of motion of the shoulder joint was restored to normal.
Basic information】Female, 50 years old
Disease Type】Shoulder joint lesion
Hospital】Harbin First Hospital
Date of consultation】May 2021
Treatment plan】Comprehensive conservative treatment (manual massage and release + ice bag cold compress + rehabilitation treatment)
Treatment period】7 days of inpatient treatment, 1 month of outpatient follow-up
Treatment effect] Pain relief, shoulder joint range of motion returned to normal
I. Initial consultation
Patient Li Auntie came to our hospital in May 2021. She reported that she had shoulder joint pain with limited active and passive shoulder joint movement, poor sleep quality due to pain at night, pain relieved at rest but worsened when she worked. After a detailed medical history, the patient indicated that he had a history of prolonged excessive shoulder joint activity. An MRI of the shoulder joint revealed inflammation around the shoulder joint and fluid accumulation in the joint cavity, which supported the diagnosis of shoulder joint pathology and the patient was admitted to the hospital for treatment.
II. Treatment history
The patient had no serious damage to important intra-articular structures of the shoulder joint. Although he had symptoms such as shoulder pain and limitation of movement, the strength of the shoulder joint was still preserved. After communication with the patient, the patient agreed to take comprehensive conservative treatment to improve the quality of life. Under general anesthesia, the patient’s shoulder joint was released by manipulation, so that the shoulder joint could fully complete the movements of forward flexion and supination, abduction and external rotation, and body side internal rotation, thus tearing the shoulder joint adhesions and restoring the range of motion of the shoulder joint. After the release, cold compresses with ice bags were applied for 72 hours to eliminate the swelling and relieve the pain, and after 72 hours, active and passive rehabilitation training was started by the rehabilitation physician to consolidate the treatment effect of shoulder joint manipulation and release and restore the function of the shoulder joint.
III. Treatment effect
After 7 days of comprehensive conservative treatment, the patient’s shoulder joint lesion was relieved, the pain symptoms basically disappeared, the range of motion was restored, and the patient was able to complete over-the-shoulder movements, and the quality of life was significantly improved, so he was discharged from the hospital. As a result of insisting on the exercise of the deltoid, supraspinatus, subscapularis and other muscles around the shoulder joint, the stability of the patient’s shoulder joint gradually improved and no recurrence occurred. According to the comparison before and after treatment, it shows that conservative treatment is more effective for the patient.
IV. Notes
The patient’s symptoms improved significantly after the conservative treatment, and as a doctor, we are truly happy for the patient. In daily life, patients should avoid excessive strain on the shoulder joint, such as frequent over-the-shoulder movements should be strictly controlled, and pay attention to strengthening the muscles around the shoulder joint to improve the stability of the shoulder joint. A good, healthy lifestyle also helps patients recover, including regular work and rest and not staying up late. If patients have clinical symptoms such as shoulder pain and limited movement after discharge from the hospital, it is important to follow up promptly to confirm the cause of the symptoms and treat them early to obtain better results. If the disease continues to develop, it is often necessary to change to surgical treatment.
V. Personal insight
In this case, the shoulder arthropathy was mainly related to degenerative changes in soft tissues, and long-term shoulder joint overactivity can induce shoulder arthropathy, which can easily lead to shoulder joint pain, deltoid atrophy and other clinical manifestations. Patients should take precautions against the causes in their daily life to help avoid the occurrence of shoulder arthropathy.