Frozen shoulder, please be serious about me!

Frozen shoulder, please be serious about me!

Periarthritis of shoulder is a common disease in our lives, especially in autumn and winter, but most people tend to ignore it. The literature explains that periarthritis of shoulder refers to degenerative aseptic inflammation of the shoulder joint capsule and surrounding soft tissues such as muscles, ligaments, and bursae, often accompanied by limited normal activities and joint pain. It is common in people aged 40-70 years old, often unilateral shoulder disease, also known as frozen shoulder, shoulder stiffness, shoulder stiffness.

【Case Introduction】

The patient is a 60-year-old female. From October 24 to 27, 2023, because the weather suddenly turned cold, she did not add clothes in time, and performed limb exercises in an open space for a long time until she sweated. She felt persistent pain in her left shoulder during the activity, but did not take any measures. Five days later, the condition gradually worsened, and the left limbs were almost unable to move, and dressing and undressing were restricted. She needed to use her right hand or help from others to move, accompanied by severe pain. The pain sometimes worsened at night and she could not fall asleep after waking up from the pain. She had a history of diabetes for 13 years and had been taking oral hypoglycemic drugs for a long time. Her blood sugar control was good, her diet was normal, her bowel movements were good, and she urinated twice at night. After this illness, after more than a month of combined treatment such as plasters, massage, ear acupuncture, gradual rehabilitation exercises and oral medications, she has basically recovered.

【Treatment method】

(1) Applying plaster

Use pain-relieving plasters, such as Yunnan Baiyao ointment, far-infrared pain-relieving patch, lumbar spine cooling gel, etc. First, massage with lumbar spine cooling gel, rub vigorously until you feel the heat, and then use far-infrared pain-relieving patch for external use. Apply it before going to bed every day, and apply the plaster.

(2) Oral medication

In case of frozen shoulder with decreased hormone levels and unbearable pain, oral Celebrex is used for pain relief, and Eperisone is used to relieve muscle spasms and stiffness, alleviating the patient's symptoms and allowing the patient to better perform limb exercise.

(3) Massage + ear acupuncture twice a week

Ear acupuncture: Disinfect the ear skin with 75% alcohol, and apply the fenugreek seed patch to the corresponding ear acupuncture points. Start at 6 am every day, press the ear acupuncture points every 4 hours, press each acupuncture point 10 times, 4-5 times a day; change the ear acupuncture points twice a week, alternate between the two ears, and 21 days as a course of treatment. The main acupuncture points are: shoulder, shenmen, adrenal gland, and the ministerial acupuncture points are kidney, spleen, liver, and endocrine, etc., and the treatment is continued for 2 courses.

Massage: mainly relax the shoulder, back, and upper arm muscles, massage the shoulder fascia and joint tendons, increase blood circulation and relieve symptoms, focus on massage of acupoints such as Shousanli, Quchi, Tianzong, Bingfeng, Fengchi, etc. Twice a week, 20 minutes each time, plus 20 minutes of electromagnetic therapy, the pain symptoms were significantly relieved after 1 month of treatment.

(4) Activities

Wall climbing: Stand facing the wall, slowly raise the affected hand to touch the wall, and after the fingers touch the wall, use the strength of the fingers to start from the waist level, and slowly use the five fingers to climb up from the bottom like a gecko, and then slowly climb down from the top to the bottom. Exercise three times a day after meals, 10 minutes each time. The height of the wall climbing should be as high as the patient can tolerate. At the beginning, you can also use the healthy hand or others to help, and exercise step by step.

Pendulum method: The patient stands and bends over, with the affected limb hanging down, and draws 10 circles in the clockwise and counterclockwise directions, twice a day, and gradually increases the amplitude of rotation as the patient can tolerate. Gradually, 1-2 kg of objects can be held in hand to carry out rotational exercises, and the exercise is carried out step by step, from small to large.

(5) Posture management

When sleeping at night, you can sleep on your back or on your healthy side. Supine position: The height of the pillow should be 6-8cm. Place a thin pillow under the affected limb to make the affected limb level with the body. Other parts should be comfortable. Healthy side position: The height of the pillow should be the width of one shoulder when the patient lies on his side. Place an ordinary pillow in front of the chest and lay the affected limb flat on the pillow for comfort.

If you persist for about 4 weeks, joint stiffness and pain will be significantly alleviated, and the range of motion will gradually be restored.

【Cause Analysis】

1. Feeling wind-cold: Most patients fail to take measures to keep warm because of the sudden cold weather, which leads to the invasion of wind, cold and dampness in the shoulders and neck, resulting in blocked shoulder meridians and cold stagnation of tendons and veins. If not treated in time, it will cause severe periarthritis of the shoulder.

2. External force: Many cases of frozen shoulder are caused by excessive local exercise, such as excessive exertion in playing volleyball, basketball, badminton, etc., or straining shoulder muscles by lifting heavy objects, or excessive movement of one action for a long time. In this case, there is excessive shoulder exercise.

3. Decreased hormone levels in the body: Periarthritis of the shoulder is more common in the middle-aged and elderly population. Existing studies have shown that factors such as diabetes, obesity, and hypothyroidism can significantly increase the incidence of periarthritis of the shoulder, and diabetes has the strongest correlation with periarthritis of the shoulder, with an incidence rate of 10%-39%. This case has a 13-year history of diabetes.

【Prognosis concerns】

Frozen shoulder is a benign, self-limiting disease, but more than 60% of patients still have varying degrees of pain or functional impairment in the later stages, affecting their quality of life. Therefore, please take the treatment of frozen shoulder seriously, seek medical attention and diagnosis in time, improve pain and joint activity early, and shorten the treatment time.

【Notes】

1. Keep your shoulders warm to avoid cold and wind on your shoulders and neck, especially when the seasons change.

2. Keep exercising, proceed step by step, and do not do strenuous labor or unload heavy objects suddenly to avoid strain. Do not maintain a posture for a long time, and exercise the shoulder joints appropriately.

3. Supplement calcium, pay attention to diet, strengthen nutrition, eat more foods rich in protein, vitamins, calcium, and iron, avoid greasy and cold foods, and get appropriate sun exposure.

In short, the treatment of frozen shoulder requires comprehensive measures including drug therapy, physical therapy and functional exercise. At the same time, attention should also be paid to prevention and health care measures such as keeping warm and exercising properly. At present, the treatment of frozen shoulder is still mainly conservative treatment. Once symptoms of discomfort and pain appear in the shoulder, please take it seriously.