Shoulder joint pain is a common disease among middle-aged and elderly people. They have the same complaints and symptoms: pain and weakness in the shoulder joint when moving to a certain angle, inability to lift the arm, frequent waking up at night with pain, and inability to lie on their side, but the mobility of the joint is basically unaffected. The pain has lasted for more than a year, and I have been to many hospitals, but I have been treated as “frozen shoulder”. I have done manual therapy, physiotherapy, Chinese medicine, acupuncture, etc. I also follow the medical advice to exercise every day, climbing the wall, pulling the hoop, stick exercises, rope exercises, but despite all kinds of conservative treatment, I still do not see any improvement. The diagnosis of “frozen shoulder” has been abused for many years, just like a “garbage can”, all the shoulder pains that cannot be understood are thrown into the garbage can of “frozen shoulder”. This has led to many missed diagnoses, misdiagnoses and mis-treatments. There are many conditions that cause shoulder pain, including rotator cuff tears, acromioclavicular impingement, rostral impingement, frozen shoulder, sternoclavicular joint disease, SLAP injury, anterior shoulder instability, tendinopathy, calcific supraspinatus tendinitis, cervical spondylosis, and thoracic outlet syndrome. One study found that among older adults over the age of 60 who visited the doctor due to shoulder pain, the percentage of rotator cuff injury and acromioclavicular impingement was as high as 70%, and its incidence was much higher than that of frozen shoulder. Introduction to common diseases: 1. Rotator cuff injury – shoulder joint pain is the main cause: What is rotator cuff? The rotator cuff is the collective name for the four tendons of the shoulder joint, which wrap around the humeral head in a sleeve shape. The rotator cuff is located between the acromion and the head of the humerus, and its main function is to help with the movement and stabilization of the shoulder joint, which is a very important group of structures. The rotator cuff is also a tendon tissue that is very susceptible to injury and tear. The mechanism of rotator cuff injury can be divided into two types: acute injury and chronic strain injury. Acute injuries are common when lifting heavy objects, supporting the shoulder when falling, being pulled by external forces, etc. For example, a passenger standing on a bus with a hand-held lever, suddenly encountering an emergency brake, may cause rotator cuff injury. Chronic rotator cuff injuries are common in elderly people over 60 years old who often participate in sports; in addition, they are more common in people who are engaged in long-term sports such as tennis, baseball, badminton, swimming and other sports that require the upper limbs to be raised above the head. Rotator cuff injuries are mainly characterized by pain during shoulder abduction and supination. In severe cases, the affected shoulder requires the help of the opposite hand to complete the supination because of the weakness of the shoulder joint, and sometimes there may be a combination of lesser degree of shoulder joint limitation. Functional exercises do not help with pain relief of rotator cuff tears. If a patient with a rotator cuff tear is allowed to perform functional exercises such as “wall climbing” or artificially pulling and releasing the rotator joint, it may cause the torn rotator cuff to continue to expand and form a huge rotator cuff tear or irreparable rotator cuff tear, aggravating the injury, which is a very disabling disease. 2. Frozen shoulder – a “garbage can” for shoulder stiffness and pain diagnosis “Frozen shoulder” is a more accurate professional name for “frozen shoulder” or “adhesive capsulitis”. Frozen shoulder” is more accurately known as “frozen shoulder” or “adhesive capsulitis”, because it occurs in middle-aged and older people in their 50s, also known as “50’s shoulder”, and has an incidence of about 2% to 5%. “Frozen shoulder” has a tendency to heal on its own, and the symptoms can be relieved on their own in about one and a half to two years, but cannot be completely restored to a normal state. Since the etiology and pathogenesis of frozen shoulder are still inconclusive, further research on the epidemiology, pathophysiology and treatment of frozen shoulder is needed. “The typical clinical manifestation of frozen shoulder is the progressive development of shoulder stiffness and shoulder pain in the middle-aged and elderly population for no particular reason. The pain may extend to the back or upper extremities and may even be accompanied by nocturnal pain, often waking up during sleep. The limitation of shoulder joint movement is even more serious, as it is difficult to lift and externally rotate the shoulder joint, and the simplest personal hygiene such as combing hair, putting on and taking off clothes, defecating and bathing becomes a “difficult” problem. The key to treating shoulder joint pain and stiffness is to make a clear diagnosis and choose different treatment methods depending on the cause of the pain. In the past, the diagnosis of shoulder joint disease was vague, so only some middle-of-the-road treatments, such as acupuncture, Chinese medicine, massage or physical therapy, could be chosen. Because of the poor efficacy, many shoulder pain patients do not go to the hospital, but simply perform functional exercises or use prescriptions based on others’ experience. In the end, the condition deteriorates. It is recommended that patients with shoulder pain and shoulder disorders first seek a clear diagnosis from a sports medicine or shoulder surgeon before receiving different treatments. In addition to Chinese medicine and physical therapy, most patients with shoulder pain can find relief with oral anti-inflammatory and pain relieving medications and local closure therapy. For patients with severe “frozen shoulder”, if the dysfunction severely affects life and work, minimally invasive arthroscopic treatment is the best treatment recommended internationally. For shoulder pain, shoulder weakness and severe dysfunction, surgical treatment should be considered. At present, arthroscopic minimally invasive surgery technology is advancing rapidly. For the treatment of shoulder diseases, arthroscopic treatment is incomparable to any other treatment and traditional incision surgery, which can relieve shoulder pain, repair torn rotator cuff and restore joint stability within a very small incision, with good efficacy, less risk and fast recovery.