Every autumn and winter, some middle-aged and elderly people will always feel shoulder pain, and young people will also have shoulder pain when they sit for a long time, what is going on? Are these conditions related to frozen shoulder?Guest of this issue
Deputy Chief TCM Physician of Wujing Community Health Service CenterMinhang District Pei Jianming old Chinese medicine studio heir Chen Jun
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About frozen shoulder
Periarthritis of the shoulder is a chronic damaging inflammation of the muscles, tendons, bursa and joint capsule around the shoulder joint, with shoulder pain, limited functional activity and muscle atrophy as clinical characteristics. Epidemiological survey data show that the incidence of frozen shoulder is 2-5%, which is more common in middle-aged and elderly people around 50 years old, more women than men, unilateral and more common, and about 20%-30% of patients have bilateral disease; There is a tendency to self-healing, and the prognosis is generally good.
Symptoms of frozen shoulderFrozen shoulder begins as pain in one shoulder or upper arm, and a small number of patients will gradually affect the neck and elbow, and release to the neck and elbow, and the pain will worsen after activity, and they will often wake up in pain at night. In the later stage, the shoulder joint is mainly restricted, and the shoulder cannot be abducted, lifted, and extended, which not only affects work, but also affects daily life, and even eats, writes, dresses and combs hair are difficult, which seriously affects the quality of life of patients. 
A disease that can be easily confused with frozen shoulder1.Subacromial impingement, labral injury, etc.:These disorders often do not have a significant decrease in shoulder range of motion and often have a history of trauma, and identification is mainly based on imaging studies. 2.Rotator cuff injury:Most of the patients are middle-aged and elderly people over 40 years old, and they often have symptoms such as shoulder lifting pain, snapping, and shoulder joint weakness, and pain arc is one of the characteristic manifestations of the disease. Patients with rotator cuff injuries tend to have a normal passive range of motion, and imaging may show signs of rotator cuff tears. 3.Cervical spondylosis:Patients have pain at the back of the neck, localized pain in the arms and palms, decreased sensation, or muscle weakness. The passive range of motion of the shoulder joint in patients with cervical spondylosis is basically normal and **, and imaging examination can show manifestations such as intervertebral foraminal stenosis and nerve root compression. 4.Shoulder tumors:Shoulder tumors are less common than other diseases, but they can have serious consequences. In order to prevent delays due to misdiagnosis**, imaging examinations should be performed for any pain that progressively worsens in the shoulder joint and cannot be relieved by immobilizing the affected limb. 5.Other:There are many conditions that can cause shoulder pain, and attention should also be paid to the investigation of frozen shoulder pain caused by permanent pacemaker insertion, dorsal scapular nerve entrapment syndrome, intrathoracic or neck and shoulder infections, chest and abdominal tumors, etc. 
Causes of the formation of frozen shoulderOld age and frailty, lack of qi and blood, blood does not nourish tendons, and the soft tissues around the shoulder joint degenerate. Chronic injuries caused by long-term overmobility and poor posture of the shoulder. Shoulder fractures, dislocations, and contusions of the joint capsule. Upper limb fractures are fixed for too long, joint capsular contractures are contracture, and shoulder joint movement is passively limited. 
How to exercise at home and prevent frozen shoulder? Gymnastics exercises:Hold the gymnastic stick with both hands, in front of the body, with the arms straight, and then repeatedly lift up forcefully, extending as far back as possible towards the back of the head; Behind the body, hold the stick with both hands and lift it up firmly. Finger wall climbing exercises:Stand on your side or in front of you, lift the forearm of the affected side, place your index and middle fingers against the wall, and then slowly climb the wall along the wall until you reach the highest point you can tolerate, then pause or press down slightly. The arm of the affected side is raised and the back of the head is repeatedly touchedPut the sick side behind the body and lift it up to touch the back. If the affected arm is immobile, the unaffected hand can be used to help lift the affected hand. 
Frozen shoulder usually lasts for a long time, which can last for several months or even a year. Therefore, patients should insist on exercising at home every day, and gradually increase the time and frequency of exercise in order to achieve better results. Exercise should be designed to cause mild pain, but severe pain should be avoided. The elderly generally lack activity, the blood circulation of the tissues around the upper limbs and shoulders is poor, and the joint capsule and tendon of the shoulder joint are prone to chronic injury, degeneration, and calcification. Therefore, we remind the majority of elderly friends that they should exercise properly and effectively exercise the upper limbs and shoulders to minimize the occurrence of frozen shoulder. 
Reporter: Wang Tingting Editor: Yue Shunshun (intern).
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