Q: What kind of disease is frozen shoulder? A: Frozen shoulder in a broad sense is a common disease, and is a general term for a group of diseases such as shoulder joint pain and shoulder joint dysfunction. In the past, there was a misconception that all shoulder pains belonged to frozen shoulder, but in fact, frozen shoulder includes at least eight diseases. Frozen shoulder” (1924, Codman), also known as “frozen shoulder”, “fifty shoulder”, “adhesive capsulitis of the shoulder”, etc., is a common and common disease. “It is a common and frequent disease (prevalence rate of 2%), especially for middle-aged and elderly people over 50 years old. It seriously affects people’s life during the onset, especially for diabetic patients (incidence rate of 20%). Yuan Feng, Specialist in Joint and Bone Diseases, Shanghai Oriental Hospital Q: What kinds of diseases are included in the broad sense of frozen shoulder? A: At present, it is believed that frozen shoulder in the broad sense includes at least eight diseases (1) frozen shoulder or adhesive capsulitis in the narrow sense. (2) Instability of the shoulder joint. (3) Acromioclavicular impingement. (4) Subacromial bursitis. (5) Calcific supraspinatus tendonitis. (6) Rotator cuff injury. (7) Intra-articular free body. (8) Long head biceps tendonitis, etc. Q: Is it true that when I find pain or dysfunction in the shoulder, I must have frozen shoulder? A: Frozen shoulder in a broad sense is actually a general concept that includes all diseases of shoulder joint pain or dysfunction except fractures, infections, and tumors. Q: Which condition is more common? A: There are three more common conditions in China: 1. frozen shoulder or fifty shoulder, which is the most common condition, mainly caused by adhesions of the joint capsule. 2. long head tendonitis of the biceps tendon. 3. injury or tear of the supraspinatus tendon. Q: Can frozen shoulder be cured by rehabilitation exercises? A: The traditional view is that frozen shoulder can be treated by rehabilitation exercises. However, it only applies to some of the narrowly defined frozen shoulder. For diseases such as rotator cuff injury, rehabilitation exercises not only do not achieve a therapeutic effect, but also aggravate the original disease. Therefore, my general recommendation is to stop the rehabilitation exercise for 3 days if it not only fails to improve the symptoms, but also aggravates the symptoms of the original pain. Come to the hospital for a consultation. Q: What are the causes of frozen shoulder? A: The causes of frozen shoulder are as follows: 1. mild traumatic sprain of the joint. 2. long-term maintenance of the same position, such as long-term use of computer lights, which reduces the movement of the shoulder joint. 3. endocrine disorders, especially the incidence of frozen shoulder is significantly higher in patients with diabetes. 4. abnormal immune function caused by infection. 5. cold. Q: Can frozen shoulder heal on its own? In what cases do I need surgery? A: According to the evolution of symptoms, frozen shoulder is divided into 3 periods: ① painful period, lasting 2.5-9 months, characterized by gradually increasing pain around the shoulder; ② stiff period, lasting 4-12 months, during which the shoulder pain is relieved and characterized by progressive reduction of shoulder mobility, including active and passive external rotation, internal rotation and abduction of the shoulder, of which the reduction of shoulder external rotation mobility is the most obvious; ③ remission period, lasting 4-12 months, characterized by progressive reduction of shoulder mobility, including active and passive external rotation, internal rotation and abduction of the shoulder. (3) The remission period, which lasts for 5 to 26 months, is characterized by a gradual recovery of shoulder mobility. Frozen shoulder has a self-limiting characteristic, the entire course of the disease is 12 to 42 months without treatment, with an average of 30 months. However, patients who have not recovered their function for more than half a year are left with sequelae that can cause lifelong regret, such as limited joint movement, secondary rotator cuff injury, synovitis, etc., and long-term pain can have a serious impact on the patient’s life. Therefore, for frozen shoulder, my recommendation is that if it has not recovered or even worsened after 6 months after a series of conservative treatments. Then arthroscopic shoulder surgery is recommended. Q: Is there any possibility of recurrence after freezing shoulder is self-healed or cured? A: Generally speaking, minimally invasive shoulder arthroscopy for frozen shoulder is less likely to recur, and it should be said that one shoulder will not recur after the onset of the disease, but the other shoulder may still suffer from frozen shoulder. Q: How can we clearly determine if we have frozen shoulder? A: First of all, you can make a preliminary judgment from the age, the patient should be 50 years old or above. We have done a frozen shoulder in his 80s, at that time, he basically couldn’t lift up, the pain was so severe that he couldn’t sleep. Of course, with the popularity of computers, there is a tendency for frozen shoulder to become younger. We did a frozen shoulder in his 30’s, and he was the president of a large company, and he basically couldn’t lift it before the surgery, but he reached normal mobility the day after the surgery. In addition the pain is mainly manifested in the upper side and anterior side of the shoulder, sometimes it also affects the neck and elbow joint. Secondly, the dysfunction is more obvious, the joint contracture occurs, and the arm abduction, forward lift, and rotation are significantly limited. We recommend that patients go to the hospital for a definitive diagnosis. We usually recommend an MRI or x-ray of the shoulder joint to determine if the patient is suffering from a combination of other diseases, such as rotator cuff injury, rotator cuff impingement syndrome, tumor, inflammation, etc. Q: What are the shoulder diseases that can be easily confused with frozen shoulder? A: Shoulder instability, impingement, subacromial bursitis, calcific supraspinatus tendonitis, rotator cuff injury, intra-articular free body, biceps longus tendonitis, etc. can be confused with frozen shoulder. Of course, frozen shoulder may also be combined with these diseases. Q: What is the best treatment for rotator cuff injury? A: If a rotator cuff injury is diagnosed, it is usually difficult to heal on its own, so we recommend going to the hospital for minimally invasive shoulder arthroscopy. Dr. Yuan Feng, a specialist in joint and bone disease at Eastern Hospital, is a speciality of shoulder arthroscopy. Q: How long does the shoulder arthroscopy procedure take? How long is the hospital stay? A: Generally, it takes 1-2 hours to complete. The hospital stay is 2-3 days. Usually the first day of hospitalization is to complete the preoperative examination, the second day of surgery, and the third day you can be discharged. Q: What kind of surgery is shoulder arthroscopy, can you briefly introduce it? A: The minimally invasive shoulder arthroscopic surgery performed by Dr. Yuan Feng, a specialist in joints and orthopedic diseases at Eastern Hospital, generally involves making 2-5 “small holes” of about 6 mm, depending on the patient’s condition. The results are very good. If the rotator cuff or glenoid labrum is damaged, anchor staples are needed, and one of the small holes should be about 1.0 cm. The digital technology combined with shoulder arthroscopy technology carried out by Dr. Yuan Feng, a specialist in joint and bone disease at Eastern Hospital, has the advantages of exact diagnosis, less surgical trauma, less bleeding, precise surgery, no need for secondary surgical removal of surgical implanted fixation consumables, and significant results, which are more personalized and less damaging than traditional shoulder arthroscopy. It is very popular among shoulder arthroscopy patients. Q: Are there any complications with shoulder arthroscopy? A: Shoulder arthroscopy is mainly related to the surgeon’s surgical technique and the patient’s rehabilitation exercise, generally our opinion is that each of them accounts for 50%. Our department is the specialty of shoulder arthroscopy, and is the department with the largest annual volume of shoulder arthroscopy in Shanghai Pudong New Area. Every year, we hold national shoulder arthroscopy classes, and our shoulder arthroscopy technology should be at the domestic and international advanced level. Dr. Yuan Feng, for the first time in the international arena, uses digital technology to assist shoulder arthroscopy in treating frozen shoulder, and the new project and technology has been awarded a project by Shanghai Health Bureau. After the surgery, we will have a professional rehabilitation physician to guide the whole recovery process, so there are usually no complications. Q: How long is the recovery period for shoulder arthroscopy? Does it heal after the surgery? A: For frozen shoulder, we usually require maximum range of motion the day after surgery. The normal range of motion and level is usually reached 1 month after surgery. Many of the patients I have operated on have gone to work within 3 days after surgery. Of course we recommend it is still best to be able to rest for about 1-2 weeks. After surgery, we will give each patient a long-term rehabilitation program, and we need the patient to adhere to the rehabilitation exercise in order to achieve the best treatment results.