When I see patients in the clinic or sometimes chat with friends, I often hear them say that they are tired from work, have shoulder joint pain and frozen shoulder again recently. In daily life, many patients do not have a clear understanding of shoulder joint disease. Sometimes these patients rely on painkillers for treatment when they get sick, but in fact, painkillers or creams only provide temporary local relief or pain control, but the root cause of the pain is still not properly treated, and the symptoms are not treated. The structure of the shoulder joint, consisting of the articular glenoid of the scapula and the humeral head, is a ball and socket joint. The articular surface of the humeral head is larger, and the area of the articular pelvis is only 1/3 or 1/4 of the articular head, therefore, the movement of the humeral head is larger. The joint capsule is thin and loose, especially the lower wall, and is attached to the circumference of the glenoid, encasing the superior glenoid tuberosity in the capsule above and the anatomic neck of the humerus below. 1. Diseases related to shoulder instability The anatomical characteristics of the shoulder joint are reflected in the thin and flaccid capsule, which has a flexible motion function. The shoulder joint is the most flexible ball and socket joint in the body and can be flexed, extended, retracted, extended, rotated and rotated in a circular motion. Therefore, the stability of the shoulder joint must be achieved by a large number of surrounding muscles. These include the supraspinatus, infraspinatus, subscapularis, teres minor, and deltoid muscles. These muscles are often referred to as the structures that make up the rotator cuff. They are mainly located above and behind the shoulder joint, while the front and bottom of the joint have fewer muscles and the joint capsule is the most flaccid, so it is the weakest point for joint stability. When the upper limb falls backwards in the abducted or externally rotated position, the palm of the hand or the elbow lands on the ground and the front dislocation of the shoulder joint easily occurs, causing instability of the joint, which is a major type of shoulder joint disease – joint instability, joint dislocation, the most common anterior and inferior dislocation, the so-called Bankart injury, and posterior dislocation, which will inevitably The most common types of dislocations are anterior and inferior dislocations, so-called Bankart injuries, and posterior dislocations. There are also some glenoid injuries, such as SLAP injuries, which are often referred to by doctors. As for whether to choose arthroscopic treatment, I personally think it depends on the experience of the doctor. If the doctor does a lot of arthroscopic surgery in this area, of course it is fine. 2. Rotator cuff related diseases From the picture above, it can be seen that the muscles of the shoulder joint stop at the head of the humerus, so they form the rotator cuff. The shoulder joint is one of the most flexible joints, so it is obvious that some degeneration can occur over the years. Therefore, the incidence of rotator cuff injury accounts for 30-40% of shoulder joint disorders, ranking first. It is a very common degenerative disease of the shoulder joint, and its occurrence is positively correlated with age. Typical symptoms are pain in the neck and shoulder at night and pain in the arm when lifting; sometimes they are afraid to sleep on the painful side or even wake up with pain; the shoulder joint may be weak during abduction, supination or posterior extension, and sometimes there are difficulties even in taking care of themselves. For patients with definite injury, surgery is sometimes necessary. For some incomplete injuries, the symptoms may improve with some medication, but may recur and turn from an incomplete injury to a complete injury. 3.Degenerative related lesions of the shoulder joint The shoulder joint, like all joints in the body, has degenerative changes with age or increased exercise. The shoulder joint is composed of six joints, divided into the acromioclavicular joint, glenohumeral joint, acromioclavicular joint, sternoclavicular joint, rostraloclavicular joint, and interscapular thoracic wall joint. Broadly speaking any joint in the body can have degenerative changes that can lead to some arthritis or tendonitis. When these diseases are not treated properly, poor rehabilitation can lead to stiffness of the shoulder joint, which is often referred to as frozen shoulder or frozen shoulder. Of course, most of these diseases can be treated conservatively or with rehabilitation, but some of them require surgical treatment, such as subacromial cleansing and plication, which is effective for some patients with impingement syndrome. Therefore, after knowing the shoulder joint and shoulder joint related diseases, please get out of the misconceptions related to these diseases. 1.Reliance on painkillers. Statistics show that among the respondents who had acute shoulder pain, most of them chose to apply ointment, use bruising wine, or take painkillers at will. The root cause of the pain is still not properly dealt with, which is not the root cause of the problem, but will lead to chronic shoulder pain. 2.Take it as it comes. Many patients will stop physical rehabilitation or medication as soon as the pain is slightly relieved. If you do not follow medical advice and act on your feelings, the inflammation or injury at the lesion may only partially recover, and it is easy to have recurring attacks in the short term. 3. Massage is equal to treatment. When shoulder pain, many people are used to soothe the pain with the help of massage. Professional massage can indeed provide some relief, but it does not get rid of the root cause. It should be reminded that inappropriate techniques will only make things worse, and may even cause damage. 4, minor problems do not need surgery. Although most shoulder diseases can be relieved or cured by various conservative treatments or rehabilitation, there are still some shoulder pains that require surgery to achieve better results. Currently, the examination and diagnosis of the shoulder joint often requires an X-ray or MR of the shoulder. These tests are sometimes considered necessary by doctors and can be completed in cooperation with them. There are two directions of treatment for shoulder disorders: 1) conservative treatment, including pain medication, physical therapy, rehabilitation, small acupuncture, closure, etc. Sometimes most of the disorders are relieved or cured, but some of them may be relapsed. 2.Surgical treatment, including open surgery and arthroscopic surgery. At present, many large hospitals in China use arthroscopic surgery for shoulder surgery, which is less traumatic and faster to recover than traditional surgery. However, there are indications for arthroscopic surgery, not every unit can be treated by arthroscopic surgery. Another point to remind you is that the level of arthroscopic surgeons in China is uneven, some doctors may not have done a few arthroscopic surgeries, or only a few knee arthroscopic surgeries, and then proceed to do shoulder arthroscopy related surgeries, lacking a good learning curve. In fact, before mirror surgery was used in orthopedics, many older specialists performed open surgery with the same good results and quicker surgery time. Therefore, for patients who can’t have arthroscopic surgery at their local hospital and don’t want to go out of town for treatment (mostly due to financial reasons or medical insurance), then ask your local doctor to give you open surgery treatment with the same effect. Therefore, it is important to go to a specialist arthroscopist when shoulder pain strikes, to get a clear diagnosis and receive proper treatment so as not to delay the condition.