Periarthritis of the shoulder, also known as frozen shoulder, is a chronic injurious inflammation of the shoulder muscles, tendons, bursa and joint capsule. Due to intra-articular and external adhesions, it is characterized by pain during activity and limited function.
**Including the following points: The disease mostly occurs in middle-aged and elderly people over 40 years old, soft tissue degeneration, and the ability to withstand various external forces is the basic factor. Chronic injuries caused by long-term overactivity and poor posture are the main triggers. After upper limb trauma, the shoulder is fixed for too long, and the shoulder tissues are secondary to atrophy and adhesion. Shoulder acute contusion, traction injury** inappropriate. Extra-shoulder factors: cervical spondylosis, heart, lung, biliary tract diseases of the affected shoulder pain, due to the long-term non-healing of the primary disease, the shoulder muscles continue to spasm, ischemia and form inflammatory foci, into real frozen shoulder.
Periarthritis of the shoulder occurs mainly around the Menghumeral joint, which includes: muscles and tendons. It can be divided into two layers, the outer layer is the deltoid muscle, and the inner layer is the supraspinatus, infraspinatus, subscapularis and teres minor four short muscles and their symphysis tendons. The symphysis tendon is tightly connected to the joint capsule and attaches to the upper end of the humerus like a sleeve, which is called the rotator cuff or rotator cuff. The rotator cuff is one of the most stressed structures in the shoulder joint and is prone to injury. The long biceps tendon arises above the joint and passes through the fibrous tunnel of the intertuberosity groove of the humerus, which is the most common area for inflammation. The short head of the biceps brachii originates from the coracoid process, passes through the medial front of the Menghumeral joint to the upper arm, and is affected by inflammation of the posterior muscle spasm, affecting the abduction and extension of the shoulder. Bursa. There are subdeltoid bursa, subacromial bursa and subcoracoid bursa. Its inflammation can interact with adjacent deltoid, supraspinatus tendons, and biceps brevis tendons. Joint capsule. The Menghumeral joint capsule is large and loose, and the shoulder has a large range of motion and is therefore susceptible to injury.
Chronic damage to these structures is characterized by hyperplasia, roughness, and intra- and out-of-articular adhesions, resulting in pain and functional limitations. Later adhesions become very tight, even with the periosteum, at which point the pain disappears, but the dysfunction is difficult to restore.
1.The disease is more common in women than in men, on the left side more than on the right side, and can occur on both sides. Most of them are middle-aged and elderly diseases.
2.The gradual appearance of pain in a certain part of the shoulder is obviously related to movement and posture. As the disease progresses, the pain becomes more extensive and involves the mid-upper arm, with limited shoulder motion. If you want to increase your range of motion, you will have severe pain. In severe cases, the affected limb cannot comb its hair, wash its face and buckle its belt, and wake up in pain at night by turning over and moving its shoulders. The patient can still point out the pain point in the early stage, but the scope expands in the later stage, and the pain is felt to come from the humerus.
3.On examination, there is mild atrophy of the deltoid muscles and spasms of the trapezius muscles. The supraspinatus tendon, biceps long, brachyceps tendon, and anterior and posterior border of the deltoid muscle can be markedly tender. The abduction, external rotation and extension of the shoulder joint are most restricted, and the adduction and internal rotation are also limited in a few people, but the forward flexion is less limited.
4.In older or older patients, plain x-rays may show osteoporosis of the shoulder, or calcification of the supraspinatus tendon or subacromial bursa.
Diseases that need to be differentiated include:1Cervical Spondylosis Cervical radiculopathy can cause shoulder pain due to irritation of the five nerve roots in the neck, and chronic traumatic inflammation can occur due to prolonged pain and muscle spasm. Therefore, cervical spondylosis can have shoulder symptoms and can also be secondary to frozen shoulder. The main differentiating point between the two is single nerve damage in cervical spondylosis, often with radicular pain in the forearm and hand, and signs of nerve localization. In addition, there are more head and neck signs than frozen shoulder. 2.Shoulder tumors Clinically, shoulder pain in middle-aged and elderly people is sometimes treated with frozen shoulder or cervical spondylosis**, thus delaying the diagnosis. Therefore, if the pain is progressively worse, the pain cannot be relieved by immobilizing the affected limb, and axial percussion pain occurs, radiographs should be taken to rule out bone disease.
1.Frozen shoulder has its natural history and usually resolves spontaneously in about 1 year. However, if you do not cooperate with ** and functional exercises, even if you heal yourself, you will be left with different degrees of functional impairment.
2.Early treatment and gentle massage can improve symptoms.
3.When pain points are limited, local injections of prednisolone acetate or dappozone can significantly relieve pain.
4.When pain persists and it is difficult to sleep at night, nonsteroidal anti-inflammatory drugs and muscle relaxants may be taken.
5.Regardless of the duration of the disease and the severity of the symptoms, the shoulder joint should be actively moved every day, and the activity should be limited to not causing severe pain. Commonly used such as climbing the wall and pulling the ring.
6.In addition to local**, frozen shoulder caused by extra-shoulder factors also needs to be carried out on the primary disease**.