bubble_chart Overview

Scapulohumeral periarthritis, commonly known as "frozen shoulder" or "fifty-year-old shoulder," is the abbreviated term for shoulder periarthritis. This condition predominantly affects middle-aged individuals around 50 years old. External contraction of wind-cold, dampness, or muscle injury due to external force can lead to chronic aseptic inflammation in local soft tissues, including the joint capsule, rotator cuff, ligaments, bursae, and muscle tendons. As a result, the disease can persist for several years or even over a decade. Initially, the condition manifests as chronic pain in a specific muscle group, gradually worsening and progressing. The shoulder pain may become sharp, stabbing, sore, or dull, often intensifying at night to the point where lying on the affected side becomes impossible. Shoulder mobility becomes severely restricted, making even simple tasks like dressing extremely difficult.

bubble_chart Etiology

The disease cause of this condition is not yet fully understood, but based on clinical observations and experimental research, it may be related to the following factors.

1. Senile degeneration: This condition is more common in middle-aged and elderly women over 40 to 50 years old, clearly associated with senile degeneration.
2. Wind-dampness and cold pathogen invasion: A significant portion of patients had a history of obvious wind-dampness and cold pathogen invasion before onset, such as living in damp environments, apoplexy from exposure to rain, or sleeping with shoulders uncovered, indicating that wind-dampness and cold invasion is one of the external disease causes of scapulohumeral periarthritis.
3. Reduced shoulder activity: The clinical characteristics of this condition show it is more common in middle-aged and older women with gradually reduced shoulder activity, with a higher incidence in the left shoulder than the right, and a higher incidence among mental workers than physical laborers. Additionally, patients with reduced or restricted shoulder movement due to certain reasons (such as upper limb fracture, shoulder soft tissue injury, cervical spondylosis, etc.) often develop secondary scapulohumeral periarthritis. These features suggest that reduced shoulder activity may be related to the onset of this condition.

bubble_chart Pathological Changes

1. Shoulder tissues, such as articular cartilage, bursae, tendon sheaths, and the long head of the biceps tendon, can exhibit varying degrees of degenerative changes.
2. The joint capsule and surrounding soft tissues develop aseptic inflammation. The inflammatory mediators released during this process cause hemodynamic changes and serous exudation. The organization of the exudate leads to adhesions between tendons, tendon sheaths, and surrounding joint tissues, reducing tissue elasticity and ultimately resulting in joint contracture, commonly referred to as "frozen shoulder." It is now widely believed that tenosynovitis of the long head of the biceps tendon is one of the pathological changes associated with this condition.

bubble_chart Diagnosis

Patients usually have no history of trauma or may have experienced very minor trauma to the shoulder or upper arm, gradually leading to pain, weakness, and restricted movement in the shoulder joint and surrounding muscles. Pain is the most prominent symptom and tends to persist. It may worsen at night, affecting sleep. The pain can cause continuous muscular rigidity, which may vary in severity. The pain and muscle spasms may be localized to the shoulder joint or radiate upward to the back of the head or downward to the wrist and fingers. In some cases, the pain may spread forward to the chest or backward to the scapular region, centered around the shoulder joint. It may also radiate to the triceps, deltoid, or biceps areas. In such cases, careful examination is necessary to differentiate it from cervical spondylosis or heart disease.

bubble_chart Treatment Measures

Scapulohumeral periarthritis, commonly referred to as shoulder inflammation, is also known as frozen shoulder or stiff shoulder. It is a chronic inflammation of soft tissues such as muscles, tendons, bursae, and joint capsules, leading to adhesions inside and outside the joint that impede shoulder movement. This condition predominantly occurs in individuals around 50 years of age, hence it is also called "fifty shoulder." Scapulohumeral periarthritis is caused by factors such as exposure to wind-cold dampness pathogens, long-term strain, and the decline of qi and blood due to aging.

In its early stages, scapulohumeral periarthritis manifests as pain or discomfort in one or several areas of the affected shoulder, with nighttime pain being more severe than daytime pain, often worsening after exertion. The intensity of pain varies widely, ranging from dull aches to sharp, knife-like pain, or even needle-like or pulling sensations. The pain is typically widespread, often radiating to the upper arm and the back of the shoulder. In severe cases, the muscles around the shoulder joint may exhibit noticeable spasms, making it difficult to comb hair or even put on clothes.

Once clinical symptoms appear, prompt treatment is essential. The preferred methods include tuina and acupuncture. Drug injections at the painful points in the shoulder can significantly reduce inflammation and alleviate pain. Alternatively, Chinese medicinals that promote blood circulation, move qi, and unblock collaterals can be decocted, and the liquid can be applied to the painful points and acupoints on the shoulder using a wooden stick to dredge collaterals and relieve pain. During recovery, it is crucial to focus on shoulder function exercises, such as wall-climbing movements with the arm, or using the healthy arm to assist the affected side in adduction, abduction, flexion, and extension exercises.

bubble_chart Prevention

The best and simplest way to prevent scapulohumeral periarthritis is to maintain regular physical exercise, such as practicing Tai Chi or doing calisthenics. Pay attention to keeping the shoulders warm in daily life, avoid exposing the shoulders to a fan while sleeping in summer, and refrain from sleeping in damp places to prevent exposure to wind-cold dampness. Prevent chronic strain in the shoulders by avoiding sudden heavy labor or lifting excessively heavy objects to prevent shoulder sprains.