Small needle knife is a new medical apparatus shaped like acupuncture needles, 0.8mm in diameter, with a flat front edge, which is a new therapy developed on the basis of the ancient K (sound “winding”) needles and sharp needles, combined with modern minimally invasive technology. It can enter the damaged tissues for loosening, unblocking, stripping and meridian adjustment without pain, so as to achieve the purpose of pain relief and disease elimination. Its indications are mainly cervical spondylosis, frozen shoulder, lumbar disc herniation, osteoarthritis, tenosynovitis, achalasia and other painful diseases. Small acupuncture therapy has the advantages of simple operation, small trauma, and remarkable curative effect, etc. No rest is needed after the operation, and patients have no obvious pain and fear, so it is easy to accept.
1.Clinical symptoms of frozen shoulder
Frozen shoulder is a common condition with shoulder joint pain and inconvenience in movement as the main symptoms. The prevalence of this disease is around 50 years old, with a slightly higher incidence in women than in men, and is mostly seen in manual laborers. If not treated effectively, it may seriously affect the functional activities of the shoulder joint and hinder daily life. In the early stage of the disease, the shoulder joint pain is paroxysmal, often triggered by weather changes and exertion, and then gradually develops into persistent pain, which gradually worsens, with light day and heavy night, unable to sleep at night, unable to lie on the affected side, and limited active and passive activities of the shoulder joint in all directions. When the shoulder is stretched, it can cause severe pain. There may be extensive pressure pain in the shoulder joint, radiating to the neck and elbow, and atrophy of the deltoid muscle to varying degrees.
2.Causes of frozen shoulder
(1) Shoulder causes
(1) The disease mostly occurs in middle-aged and elderly people over 40 years old, with degenerative soft tissue disease and weakened ability to withstand various external forces being the basic factors; (2) Chronic injury caused by long-term overactivity and poor posture is the main causative factor; (3) Shoulder pain after upper limb trauma is the main cause.
③ The shoulder is fixed for too long after upper limb trauma, and the periapical tissues develop secondary atrophy and adhesions.
(4) Improper treatment after acute contusion or strain on the shoulder.
(2) Extra-shoulder factors
Cervical spondylosis, heart, lung and biliary tract diseases occurring in the shoulder involvement pain, due to the long-term failure to heal the original disease so that the shoulder muscle persistent spasm, ischemia and the formation of inflammatory lesions, transformed into the real frozen shoulder.
The shoulder joint is the joint with the largest range of motion of any joint in the body. Its joint capsule is loose and the stability of the joint is mostly maintained by the strength of the muscles, muscles and ligaments around the joint. Because of the poor blood supply to the tendons and the degenerative changes that occur with age, and the frequent activities of the shoulder joint in life, the soft tissues around the shoulder are prone to inflammatory exudation, which can lead to adhesions and the formation of frozen shoulder.
3.Treatment of frozen shoulder
Although most periarthritis can heal on its own, the course of the disease can be as long as one and a half to three years. The longer the time, the greater the pain. Therefore, only active treatment can minimize the patient’s pain. Its treatment is mainly aimed at joint pain, joint stiffness and functional impairment.
(1) Drug treatment.
Generally, drugs such as ibuprofen, diclofenac sodium (Fotarine), diclofenac pain, Intazing, Daphne, Emmerich, Mobic, Naprophenone, etc. are available. Some patients can be locally injected with hydrocortisone acetate or tretinoin acetate, Depo-Provera, limetasone, etc., but most believe that they should not be used more than 3-4 times in a year, much less continuously.
(2) Functional exercise.
Due to the pain of shoulder joint and afraid to move the shoulder, thus the shoulder capsule adhesions become more and more serious until the joint is stiff and the activity is severely restricted. In treatment, functional exercise should be actively used on the basis of analgesia to restore the function of the shoulder joint to the maximum extent. Functional exercise should be frequent and appropriate, and move the shoulder joint as much as possible.
(3) Acupuncture, physiotherapy, tuina, fire cupping, etc.
(4) For cases with advanced adhesions that are firm and seriously affect the patient’s quality of life, treatment with small needle knife release can be used to obtain miraculous results.
4.The mechanism of small needle knife treatment for frozen shoulder
(1) “Balloon” theory
The onset of frozen shoulder is due to inflammatory exudation under the action of various pathological factors (wind, cold, dampness, trauma), which in turn forms a local high-pressure area. If the balloon is continuously inflated, the volume of the balloon will increase and the tension of the nerves attached to the balloon will also increase, resulting in pain. The sensory nerve endings will also bear the corresponding tension, at this time there is traction stimulation (muscle tension or spasm) can cause pain, small needle knife can make the fascial cavity pressure restored, the pain disappeared.
(2) The theory of “tearing cloth”
With the development of the disease, the inflammation is absorbed, but the inflammatory lesion destroys the original muscle fibers and capillaries and ligaments, then the body will repair itself, in the repair process, if the patient is afraid of pain, lack of appropriate functional activities and exercise, that is, adhesions, it is similar to the mechanism of soft tissue adhesions after surgery, with adhesions, the formation of the patient’s upper limb dysfunction, our treatment should be loosened The connection. Small needle is the best way to release adhesions. It is much less invasive than surgical release. It is also less risky and has advantages over closure, which does not completely release adhesions and is prone to recurrence. So how does a small needle loosen extensive adhesions? For example, if a piece of cloth is grasped with two hands, it is not easy to tear it, but if a small cut is made with scissors in the middle of the cloth, it will be torn open. Similarly. If you use a small needle to loosen the most serious adhesions (the same effect as scissors) and then combine it with the doctor’s treatment and the patient’s functional exercise, the adhesions will be completely restored.
5.Prevention of frozen shoulder
(1) Pay attention to cold and warmth: cold and dampness constantly attack the body, which can cause muscle tissue and small blood vessels to contract. Longer muscle contraction can produce more metabolites, such as lactic acid and pain-causing substances, which can stimulate muscle tissue and cause spasm, which can lead to fibrous degeneration of muscle cells, muscle contraction dysfunction and various symptoms. Therefore, in daily life, pay attention to the cold and keep warm, especially to avoid cold shoulder.
(2) Strengthen functional exercise: such as wall climbing exercise, posterior body pulling exercise, external rotation exercise and bladder shaking exercise. Pay special attention to the movement of the joint. You can often play taijiquan, taiji sword, gateball, or do exercises at home such as hanging with both arms, using tensioners, dumbbells and swinging with both hands, but pay attention to the amount of exercise so as not to cause damage to the shoulder joint and its surrounding soft tissues.
(3) Correct bad posture: For people who often work with their shoulders in abduction, they should pay attention to adjusting their posture to avoid chronic strain and accumulative injury caused by long-term bad posture.
(4) Pay attention to related diseases that can easily cause secondary frozen shoulder, such as diabetes, cervical spondylosis, shoulder and upper limb injuries, thoracic surgery and neurological diseases. People with these diseases should closely observe whether they have shoulder pain symptoms and whether the range of motion of the shoulder joint is reduced, and should carry out active and passive exercises of the shoulder joint to maintain the mobility of the shoulder joint.
(5) For patients who have developed frozen shoulder, in addition to actively treating the affected side, prevention should also be carried out on the healthy side. Some studies have shown that in 40% of patients with frozen shoulder 5-7 years after the disease, frozen shoulder will occur on the opposite side; in about 12% of patients, frozen shoulder will occur on both sides. Therefore, targeted preventive measures should also be taken for the healthy side.