[Periarthritis is generally referred to as frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder, frozen shoulder. It is an aseptic inflammation of the soft tissues surrounding the shoulder joint. It is a common and frequent disease in the elderly, and is slightly more common in women than in men. The pain is severe in the acute phase of the disease, and in the later phase, the shoulder joint movement is limited due to inflammatory adhesions. [The course of the disease can be roughly divided into 3 stages according to the occurrence and development of frozen shoulder, namely, acute stage, chronic stage, and recovery stage. There is no clear boundary between the stages, and the duration of each stage varies greatly from person to person. The main symptoms are shoulder joint pain, muscle weakness, and impaired movement. Pain is the most obvious symptom. The degree and nature of pain varies widely, from dull pain to knife-like pain, which is persistent. Third, signs Acute phase: This is the early stage of frozen shoulder. The pain in the shoulder is spontaneous, and its pain is often persistent with varying performance. Some of the pain is acute, but most of it is chronic, and some of it is only uncomfortable and binding. The pain is mostly limited to the anterolateral aspect of the shoulder joint and may extend to the point of resistance of the deltoid muscle, often involving the scapular area, upper arm or forearm. The pain is aggravated during activities, such as shrugging or internal rotation of the shoulder while wearing a shirt, and it is not possible to comb the hair and wash the face, and the affected hand cannot feel the back. Later, the shoulder pain increases rapidly, especially at night, and the patient does not dare to lie on the affected side. Due to muscle spasm and pain, the range of motion of the shoulder joint is gradually reduced, especially the limitation of abduction and external rotation is the most significant. The appearance of the shoulder is normal. The local pressure points are mostly located in the inter-nodal groove and rostral process. The subacromial bursa or deltoid attachment, supraspinatus attachment, and the internal superior scapular angle. Chronic phase: Shoulder pain gradually decreases or disappears, but the contracture and stiffness of the shoulder joint gradually increases in a frozen state. The shoulder joint activity in all directions is 50% to 20% less than normal. In severe cases, the shoulder-humeral joint activity disappears completely, and only the scapulothoracic wall joint activity is present. It is difficult to comb the hair, put on clothes, lift the arm, and knot the belt backwards. Mild muscle atrophy may occur in long-standing cases, mostly in the deltoid and scapular band muscles. The pressure pain is mild or non-existent, but it lasts for a long time, usually 2 to 3 months. Recovery period: Shoulder pain basically disappears, individual patients may have slight pain. The shoulder joint slowly relaxes and the movement of the joint gradually increases, with the external rotation activity returning first, followed by abduction and internal rotation. The length of the recovery period is related to the duration of the acute and chronic phases. The longer the freezing period, the slower the recovery period; the shorter the disease period, the faster the recovery. The entire course of the disease can take as short as 1 to 2 months, but the onset of the disease can take up to several years. Frozen shoulder is a soft tissue disease, so ordinary X-rays usually do not show any abnormal findings and are not directly helpful for diagnosis, but can exclude bone and joint diseases. Occasionally, osteoporosis and cystic changes in the acromion and greater tuberosity can be observed over time. Calcification of the supraspinatus tendon is seen as a shadow of increased density at the greater tuberosity, and osteosclerosis at the acromion, with irregular margins and other releases present. Shoulder-humeral arthrography can identify shoulder adhesions and serve as a diagnosis of rotator cuff injury. The subacromial bursa disappears, the subacromial wall gap is closed, the filling of the long head of the triceps tendon sheath decreases, and the volume of the joint cavity decreases significantly, from the normal 20-30 ml to 3-5 ml. If there is an abnormal shadow of contrast entering the subacromial bursa or the subdeltoid bursa, the diagnosis of rotator cuff rupture can still be established. The subacromial bursa angiography can show atrophy of the bursa. [Differential diagnosis] I. Brachial plexus neuritis Brachial plexus neuritis occurs mostly in young adults, more often in men, with a history of infection; periapical neuritis occurs mostly in the elderly, more often in women than men, without a history of infection. Brachial plexus neuritis is often acute, with pain in the supraclavicular fossa and shoulder, pain that is flame-like, some persistent, and may increase paroxysmally. The pain may radiate to the whole upper limb, and there may be different degrees of limb paralysis and muscle atrophy. Sometimes the lesion may extend to the opposite side and the same symptoms may appear. Frozen shoulder is a slow-onset disease with pain in the shoulder-humeral joint and soft tissues around the graspers. There is pressure pain in the brachial nerve trunk, with weakened strength and reduced tendon reflexes; in frozen shoulder, the pressure pain is widespread, mostly around the shoulder joint, with normal muscle strength and no change in tendon reflexes. Shoulder and hand syndrome Shoulder and hand syndrome is a syndrome caused by abnormalities in the plant nerve function of the upper extremity; frozen shoulder is a geriatric disease in which the pain and activity of the shoulder joint is limited by the surrounding soft tissue lesions. Shoulder syndrome occurs in young people who are emotionally unstable and have poor pain tolerance. Myocardial infarction, cervical disc disease and shoulder joint disease can trigger this disease. The main symptoms of frozen shoulder syndrome are shoulder and hand pain, swelling and stiffness of the fingers. The main symptoms of frozen shoulder are pain in the shoulder joint and its surrounding soft tissues, without hand pain, swelling and stiffness, and without various symptoms caused by plant nerve disorders, with limited movement of the shoulder joint in all directions and extensive local pressure points. C. Thoracic outlet syndrome is often caused by cervical ribs, excessive length of the transverse process of the 7th cervical vertebra, deformity of the 1st rib, abnormal anterior oblique angle, etc. It is caused by compression of the brachial plexus nerve and subclavian artery in the suprathoracic region, mostly seen in women over 30 years of age. The neck, shoulder and back pain on the affected side may radiate from the posterior part of the scapula to the ulnar side, and in some cases, it is numbness and heaviness. It is often aggravated by persistent activities of the hand or upper limb, and in severe cases, there may be weakened finger strength, inflexible fine movements, hypesthesia or allergy mainly in the distribution of the ulnar nerve, and in late stage, patients may see atrophy of the interosseous muscles and interosseous muscles, and compression of the subclavian artery may cause coldness and fear of the limb, weakness, pallor and edema when the hand is lifted. X-rays can often reveal cervical ribs, overgrown transverse processes of the 7th cervical vertebra, deformities of the 1st rib and other thoracic outlet deformities. Suprascapular nerve entrapment syndrome The lesion site of suprascapular nerve entrapment syndrome is in the scapular notch bone and ligament canal; while in frozen shoulder, it is in the scapulohumeral joint and the surrounding soft tissue. In suprascapular nerve entrapment syndrome, the shoulder pain comes from the entrapment of the suprascapular nerve and the pain is intermittent; in frozen shoulder syndrome, the pain comes from the spastic muscles of the shoulder and the pain is continuous. In scapular nerve entrapment syndrome, the shoulder abduction and external rotation strength is reduced, and there is obvious atrophy of the supraspinatus and infraspinatus muscles on the affected side, with no localized pressure pain; in frozen shoulder syndrome, all aspects of shoulder activity are obviously limited, without muscle strength reduction, and muscle atrophy is mostly seen in the deltoid muscle, with extensive pressure pain around the shoulder joint. [Treatment] Treatment I. Chinese medicine treatment In the early stage of frozen shoulder, Chinese medicine can be used to treat with papaya pills, small active ingredients and Guogong wine. For soup, use the following formula: Chai Hu 10g, Angelica Sinensis 10g, Bai Shao 10g, Chen Pi 10g, Qing Han Xia 10g, Qiang Wu 10g, Radix Platycodon 10g, White Mustard Seed 10g, Black Pill 10g, Gentiana Macrophylla 10g, Poria 10g. Take with white wine as a guide, decoction in water, twice daily after meals. In the late stage of frozen shoulder, Chinese herbal medicine can be used to treat Dahuluo Dan, Shu Jing Wu Luo Wan and Wu Jia Pi Wine. For soup, we can use the following formula: Angelica sinensis 30g, Salvia miltiorrhiza 30g, Gui Zhi 15g, Radix Rehmanniae 30g, Qiang Wu 18g, Radix et Rhizoma Polygonatum 30g, Radix Aromaticum 10g, Cao Wu 9g, Lonicera japonica 40g, Mulberry 20g. Decoction with water, taken twice daily. Second, functional exercise Currently, most scholars believe that taking pain-relieving drugs can only treat the symptoms and temporarily relieve the symptoms. The use of surgical release methods can easily cause adhesions after surgery. Therefore, the use of Chinese medicine is considered to be the best treatment option. If patients can adhere to functional exercises, the prognosis is quite good. The following are eight kinds of self-preventive actions for patients with frozen shoulder: (1) Elbow flexion and hand shaking, where the patient stands with his back against the wall or lies on his back in bed with his upper arm against his body, flexing his elbow and using the elbow point as a fulcrum for external rotation activities. (2) Finger climbing, the patient stands facing the wall, slowly climbing upward along the wall with the affected finger, making the upper limb as high as possible, to the maximum, making a mark on the wall, and then slowly going back down to the original place, repeatedly, gradually increasing the height. (3) Posterior hand pulling, the patient stands naturally, in the posture of the affected upper limb internally rotated and posteriorly extended, the healthy hand pulls the affected hand or wrist, gradually pulling to the healthy side and pulling upward. (4) Standing with arms extended, the patient’s upper limbs naturally droop, arms straight, palms down and slowly abducted, lift upward with force, stop for 10 minutes after reaching the maximum, then return to the original position and repeat. (5) Posterior extension of the spine, the patient stands naturally, in the posture of internal rotation and posterior extension of the affected upper limb, bending the elbow, flexing the wrist, the middle finger finger touching the spinal spine, from the bottom gradually upward to the maximum and then stay still, after 2 minutes and then slowly downward back to the original place, repeatedly, gradually increasing the height. (6) combing hair patients standing or supine can be, the affected side of the elbow flexion, forearm forward up and rotate forward (palm up), try to rub the forehead with the elbow, that is, sweat wipe action. (7) Head resting on both hands, the patient lies on his back, crosses the fingers of both hands, palms up, and puts them on the back of the head (occiput), first makes both elbows inward as much as possible, and then extends them as much as possible. (8) Shoulder rotation, the patient stands up, the affected limb drops naturally, the elbow is straightened, and the affected arm is circled from the front upward to the backward, the amplitude is from small to large, repeated several times.