Shoulder pain

What is shoulder periarthritis

Periarthritis of the shoulder, commonly known as 50 shoulders, also known as frozen shoulder, is a condition where shoulder pain is accompanied by stiffness of the shoulder joint, which limits movement in all directions. Periarthritis of the shoulder is one of the most common diseases of shoulder joint pain. It is mainly caused by people around the age of 50, but this is not an absolute concept. It is believed that it also occurs in the 1960s and 1970s, as well as in the twenties and thirties. However, according to statistics, most cases occur around the age of 50. It also has a noun called Frozenshoulder in our academic community, which refers to the stiffness of the shoulder joint, which reflects the characteristics of shoulder periarthritis. When we notice pain, it is accompanied by stiffness of the shoulder joint. So, what is rigidity? The movement in all directions is very limited, and there is a particularly stiff feeling. For example, our normal shoulder joint can be raised up to 180 degrees, and abduction can also reach 180 degrees. For example, it is like we can touch a very high position on the back, but after suffering from scapulohumeral periarthritis, our arms cannot be lifted, and we can only lift them up to about 80 or 90 degrees, and abduction can reach 80 or 90 degrees, which may not even be able to do external rotation.

How to treat shoulder periarthritis

1. Surgical treatment may not necessarily be suitable

The treatment of scapulohumeral periarthritis is mainly divided into conservative treatment and surgical treatment. Surgical treatment has a fast recovery and therapeutic effect, but here I want to tell everyone that surgical treatment may not necessarily be suitable for our shoulder periarthritis. In clinical practice, Western doctors may have more opportunities for surgery because Western patients are more aggressive and hope that the pain will disappear quickly, and then they hope to receive the doctor's help. In addition, the medical insurance system in the West is very sound, especially in developed countries where surgeries can be reimbursed and they hope to recover to exercise as soon as possible. You can see that people around the age of 50 suffer from shoulder periarthritis, but they are still in the peak period of exercise, especially for many people such as skiing and horseback riding. Westerners hope to recover as soon as possible. In fact, in my experience, after surgery, recovery may not necessarily be particularly fast. It has its own problems, and for us Chinese people, we still hope to use conservative treatment as the main treatment method. Conservative treatment usually involves taking painkillers or using topical medications, and then increasing activity and exercise to increase the range of motion of one's shoulders and upper arms, gradually allowing the shoulders to return to normal.

2. Several aspects of conservative treatment

Oral and topical drugs

The symptoms of scapulohumeral periarthritis are mainly pain and limitation, so our treatment mainly focuses on these two aspects. You can take painkillers, or apply some trauma painkillers or latex agents of Futalin externally. Some people even like to apply plasters, and some even use massage or cupping methods.

Actually, I want to tell everyone that among these conservative treatment methods, painkillers are the most effective and reliable. However, patients must not always take pain relievers, because after taking pain relievers for a long time, the cause of your shoulder pain itself will be ignored, so patients will not be treated according to the cause. For example, if you have diabetes, you just take pain relievers, and finally do not find that it is due to high blood sugar, which will delay your treatment.

Massage and cupping are not recommended as treatment methods

The treatment methods mentioned earlier, such as cupping and massage, actually have a particularly high risk, because periarthritis of the shoulder is pathological inflammation of the tissue around the shoulder joint. In fact, the tissue around the shoulder joint becomes stiff, leading to the accumulation of fluid in synovitis. In this situation, if you apply hot compress again, it is easy to cause a more significant increase in fluid accumulation, and the inflammation worsens faster, leading to slower recovery. The reason is that as inflammation of the shoulder joint worsens, there will be intra articular bleeding, making it more difficult to treat periarthritis of the shoulder. So, in clinical practice, it is advocated to apply ice compress after activity. We need to reduce the tearing of tissues caused by shoulder joint activity by cooling down, which can accelerate the healing process of shoulder periarthritis.

Activity training to achieve rehabilitation goals

(1) Forward bending exercise

Increasing activity through exercise is the most fundamental exercise. For example, if periarthritis of the shoulder is particularly severe in the early stages, we can have him bend down and lie on the table, then let this hand continue to crawl forward, lean the body forward, and let the hand lean forward as much as possible. This is called table climbing, which is quite serious; With the later stage of exercise, the patient's ability becomes stronger and the range becomes larger. They can climb a wall, which means placing their hands on the wall and then climbing straight up bit by bit, pressing hard. This is our most common exercise method. It is particularly important to note that there are several important time points to tell everyone: we usually need to make our arms ache twice at the same angle in order to be effective. Between the two times, you can rest for 15 to 20 seconds, each process lasting about one minute, and then put it back to rest. Do it once a day and do it at most twice. This exercise method is commonly referred to as forward bending exercise.

Table Climbing Training

Wall climbing training

(2) External rotation exercise

In fact, we also have a particularly important external rotation exercise in clinical practice. Patients with scapulohumeral periarthritis often have severe limitations in external rotation. Therefore, during exercise, our big arms are tightly attached to the upper body, and in this case, we use his good hand to push the bad hand and turn it outward to the maximum angle. The principle of pain is the same as climbing a wall just now, and the number of exercises is also the same. This way, exercising once or twice a day is enough.

Passive external rotation without twisting the body

(3) Remember to apply ice after practice

After exercising, the patient must apply ice because our tissue has been torn. Because ice compress can not only lower the temperature of the injured area, but also reduce inflammation and muscle spasms, alleviate pain, and suppress swelling.

Apply ice to the affected area for 15-20 minutes each time