Shoulder arthritis is a common and frequent disease in clinical practice. Most of the patients are aged between 50 and 60 years old and often fail to receive timely diagnosis and treatment, resulting in failure to lead a normal life, and some patients do not have enough time to explain the characteristics and precautions of the disease to their doctors. This situation causes patients to go to the doctor several times, and the mental pressure and financial burden becomes heavier and heavier;
Some patients even listen to the incorrect treatment methods or methods, resulting in more serious shoulder joint injuries, which eventually lead to irreversible dysfunction. Therefore, I think it is very important to provide a brief and detailed guide to patients with periarthritis of the shoulder here.
Concept: This disease is commonly referred to as “fifty shoulder”, but there is no international definition. In this case, we define it as “fifty shoulder” as a disease of the shoulder joint that is characterized by pain and joint contracture in middle-aged and elderly people aged 50 years old, without trauma. Periarthritis of the shoulder joint can be understood as “fifty shoulder” in many fields, but the main difference with “fifty shoulder” is that it is a more widespread disease with pain independent of age.
Etiology: The etiology of “fifty shoulder” is not clear. It is generally believed that age-related degenerative changes in the soft tissues surrounding the shoulder joint (tendon plate, long head of the biceps muscle, etc.) produce aseptic inflammation of the subacromial bursa and shoulder joint, leading to shortening of the joint capsule and resulting in impaired shoulder motion. The disease has a tendency to heal on its own, but the cause is unknown. In Europe and the United States, the disease is more commonly referred to as “adhesive capsulitis”.
Symptoms: It is common between the ages of 40 and 60 years and has a gradual onset, resulting in scapular pain and impaired motion.
The pain is characterized by cold and is apparent at night, spreading to the upper arm and elbow.
Characteristics of mobility disorders: Difficulty in combing hair because of restricted external rotation; difficulty in tying shoelaces because of restricted internal rotation.
Staging.
Contracture phase
The freezing phase, in which the voluntary movement of the shoulder joint is limited due to pain;
contracture phase
frozen phase, in which the passive movement of the shoulder joint is also limited due to contracture of the joint capsule;
Recovery phase
In the recovery phase, both pain and range of motion of the joint are improved.
Prognosis: The prognosis of this disease is good, and most patients experience significant relief or disappearance of symptoms after 1 year or 1.5 years.
Treatment.
The treatment of this disease mainly relies on life guidance, warmth therapy, exercise therapy, and if necessary, oral or topical non-steroidal anti-inflammatory analgesic drugs to relieve pain. Due to the lack of understanding of the disease, the majority of patients tend to focus on the treatment of medication, but ignore the main means of treatment, when I went out to the clinic, the most patients for me is “doctor, I take what medicine can be good”, in fact, this is a big misunderstanding of treatment.
1.Life guidance: The main thing is to pay attention to rest, limit excessive joint activity, and not to artificially cause damage to the shoulder joint;
2.Thermal therapy: Recommend patients to apply hot compresses and take hot baths;
3.Exercise therapy: gradually and slowly after the pain is controlled or relieved. It is recommended that patients first apply hot compresses for 30 minutes before the exercise therapy, and then carry out the following exercise therapy, and apply cold compresses for 30 minutes after the exercise therapy.
The main exercise therapies are
A: Codman gymnastics, bending the upper body, holding a table in one hand and a dumbbell of appropriate weight in the other, rotating the dumbbell side back and forth inside and outside.
B: flexion exercise, the healthy side of the hand holding the affected wrist, pulling toward the head.
C: internal rotation exercise, put both hands behind the back, the healthy side of the hand holding the affected side of the wrist, pulling upward along the direction of the spine.