Frozen Shoulder – A Garbage Can of Shoulder Stiffness and Pain Diagnosis

  Misdiagnosis and mismanagement of shoulder pain are common in patients who visit the doctor because the differential diagnosis of shoulder pain is very difficult and orthopedic surgeons without specialized training in shoulder surgery are not sure of the diagnosis. The diagnosis of “frozen shoulder” has been abused for many years and is like a “garbage can”. All shoulder pains that cannot be understood are thrown into the garbage can of “frozen shoulder”. This has resulted in many missed diagnoses, misdiagnoses and mis-treatments.  The more accurate professional name for “frozen shoulder” is “frozen shoulder” or “adhesive capsulitis”, because it occurs in middle-aged and older people in their 50s, also known as “It has a prevalence of 2% to 5%, and is more common in women than men. “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 normal. 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 presentation of frozen shoulder is a gradual development of “shoulder stiffness” and “shoulder pain” in middle-aged and elderly people with no specific cause. 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, manifested by difficulties in lifting and external rotation of the shoulder joint, which makes the simplest personal hygiene such as combing hair, putting on and taking off clothes, defecating and bathing become “difficult”.  The key to treating shoulder joint pain and stiffness is to make a clear diagnosis and choose different treatment methods according to the cause of the pain. In the past, the diagnosis of shoulder joint disease was vague, so only some middle-of-the-road therapies, such as acupuncture, Chinese, massage or physical therapy, could be chosen. Because of the poor efficacy, many patients with shoulder pain do not go to the hospital, but simply perform functional exercises or use prescriptions based on other people’s experience. For patients with “frozen shoulder”, there is a tendency for self-healing, while for patients with rotator cuff tears, impingement and SLAP injuries, they are often misdiagnosed and mistreated, which eventually causes the condition to deteriorate.  It is recommended that patients with shoulder pain and shoulder disorders first seek a clear diagnosis from a sports medicine or shoulder surgeon and then receive different treatments. In addition to Chinese medicine and physical therapy, most patients with shoulder pain can obtain relief through oral anti-inflammatory and pain medication and local closure therapy. For patients with severe “frozen shoulder”, if the dysfunction seriously affects life and workers, 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.