Shoulder joint dysfunction, inability to lift the upper limb is called "shoulder not lifting".

Lingshu. Jingmai refers to it as "shoulder not lifting", Zhenjiu Jiayi Jing refers to it as "shoulder not lifting" and "arm cannot be raised above the head", Jingui Yaolue refers to it as "only arm not functioning".

Shoulder not lifting and shoulder pain often coexist clinically. Shoulder pain leading to shoulder joint dysfunction, even inability to lift the upper limb, if the shoulder pain is cured, the symptom of inability to lift the shoulder will also be cured, see the section on shoulder pain. If shoulder pain is caused by inability to lift the shoulder, the more severe the shoulder joint dysfunction, the more severe the pain, and the pain will only be eliminated when the shoulder joint function returns to normal. Clinically, the two are often difficult to distinguish. Therefore, when shoulder not lifting and shoulder pain coexist, it can be referred to as "shoulder pain cannot be lifted", "heavy shoulder not lifting, arm pain", "heavy shoulder and elbow arm pain, cannot be lifted", "shoulder and elbow pain, difficult to flex and extend, hand cannot be lifted", "shoulder pain cannot be lifted by oneself", "shoulder pain cannot dress oneself", "shoulder pain as if breaking, arm as if being pulled, hand cannot move up and down" (Zhenjiu Jiayi Jing), etc.

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1. Bi Pain︰More severe shoulder pain that persists for a long time may lead to the inability to lift the shoulder. In this condition, shoulder pain occurs first, and if it persists without relief, it eventually leads to the inability to raise the shoulder. The shoulder often feels cold and chilly, with a preference for warmth. While warmth may temporarily alleviate the pain, the cold sensation and pain return after some time. Due to the prolonged course of the condition, muscle atrophy and Jingjin stiffness often occur. The tongue texture is pale with a white coating, and the pulse is wiry or wiry-thin. Although commonly seen in the elderly, it can also occur in young or middle-aged individuals with weak constitutions. It is caused by the invasion of wind-cold dampness pathogens, especially cold-dampness pathogenic qi, lodging in the Jingmai and muscles, obstructing yang qi. Hence, the shoulder often feels cold, and pain worsens in damp and cold conditions. If left untreated for a long time, it may lead to restricted shoulder joint movement or even the inability to lift the arm. This condition begins with shoulder pain, and due to its prolonged course, it gradually affects the upper limb, making it difficult to lift. Treatment primarily focuses on warming the meridians and dissipating cold to relieve pain. Since the condition is chronic, qi stagnation often leads to blood stasis, so blood-activating and stasis-resolving herbs such as Turmeric, Frankincense, Myrrh, Trogopterus Dung, Peach Kernel, Carthamus, and Ground Beetle are often added. Formulas like Juanbi Tang or modified Five Accumulations Powder may be used. For chronic cases accompanied by blood deficiency, modified Juanbi Four Ingredients Decoction can be applied. For related conditions, refer to wind-cold shoulder pain and phlegm-dampness shoulder pain in the shoulder pain section.
2. Shoulder Stiffness︰Also known as scapulohumeral periarthritis or "frozen shoulder," this condition commonly occurs in the elderly, particularly postmenopausal women. It often affects one side, though occasionally both sides may be involved simultaneously. Patients typically cannot identify a clear cause but suddenly experience shoulder pain and restricted joint mobility. Symptoms progress slowly over days or months, leading to severe functional impairment of the shoulder joint, making it difficult to lift the arm. Pain intensifies as mobility worsens, becoming tolerable during the day but excruciating at night, often disrupting sleep. The reluctance to move the arm due to pain further exacerbates stiffness and discomfort, creating a vicious cycle. Pain may radiate to the upper arm, elbow, or hand. Prolonged cases result in muscle atrophy and rigidity, rendering the shoulder joint immobile and complicating daily activities like combing hair or dressing. The shoulder may feel cold, and spontaneous sweating may occur in the palms. The pulse is thin, and the tongue may appear normal or pale if qi and blood deficiency are present, or purplish with static blood stasis. This condition is one of the common limb pain disorders in elderly women after menopause, often without a history of wind-cold-damp exposure, though it may occasionally be triggered by minor trauma or external pathogens. Shoulder pain and functional impairment occur simultaneously, worsening progressively and severely affecting sleep and daily life. Muscle atrophy and stiffness reduce the joint's range of motion, sometimes completely preventing arm elevation. Nighttime pain is particularly unbearable. While warming the meridians, dispersing cold, dredging collaterals, and pain-relieving medications or acupuncture may temporarily alleviate symptoms, restoring arm function is challenging. Treatment parallels that for chest obstruction with shoulder immobility. Functional recovery depends on the patient's perseverance in performing appropriate exercises despite pain or undergoing tuina to relax contracted muscles. As shoulder mobility improves, pain gradually diminishes and eventually resolves.
3. Chest Impediment︰This certificate pertains to a more severe case of shoulder immobility. The patient often has a history of chest obstruction syndrome, presenting with shortness of breath, palpitation, chest tightness, precordial pain, or even chest pain radiating to the back, frequently accompanied by symptoms of static blood. The nature of the chest pain is stabbing, and the tongue texture appears purplish-dark or with ecchymosis. It commonly occurs in the elderly. Shoulder pain is accompanied by swelling and pain in the fingers of the affected side, rendering the shoulder unable to lift, while the fingers on the same side also cannot flex or extend due to pain and swelling. The pain is intense, worsening at night, and may even cause sleeplessness throughout the night. However, the elbow joint is usually unaffected. The affected upper limb exhibits profuse sweating, particularly in the hand. If the condition persists without improvement, the upper limb muscles may atrophy, and the fingers and nails may take on a waxy yellow hue, becoming stiff and deformed (often flexed) and unable to bend or extend. It can occur in both men and women and is often accompanied by symptoms of chest obstruction, such as chest pain or chest pain radiating to the back, palpitation, shortness of breath, and a purplish-dark tongue color or ecchymosis. The pain in the shoulder and hand is severe, with swollen fingers often appearing waxy yellow. If prolonged, the fingers may become semi-flexed and rigid, making recovery difficult. Treatment primarily focuses on invigorating blood and dispelling stasis, moving qi to relieve pain. The prescription may include Immature Orange Fruit, Longstamen Onion Bulb, and Cinnamon Twig Decoction supplemented with Salvia, Red Peony Root, Trogopterus Dung, frankincense, and myrrh; or Resistant and Withstanding Decoction with modifications. It frequently occurs in the elderly, often accompanied by qi deficiency or blood deficiency. For qi deficiency, it may be combined with Zhengyuan Decoction, and for blood deficiency, it may be paired with Four Ingredients Decoction to tonify qi and blood deficiencies.
4. Damage︰Adults who experience impaired shoulder joint function and inability to lift the arm due to a sudden sprain injury to the shoulder muscles must have a clear history of injury. The injured area may show swelling, though some cases may not exhibit visible swelling, but local tenderness is evident. The onset is sudden, and the course is relatively short. As the sprain injury heals, shoulder function gradually recovers. In children, particularly preschoolers aged five to seven, sudden inability to lift the upper limb, with severe pain upon forced passive lifting, is characteristic. The child may tilt the torso first toward the affected side and then to the healthy side, using the body's swaying motion to barely "swing up" the affected limb, yet still unable to raise it to shoulder level. Upon careful examination, mild swelling or grade I ecchymosis may be observed at the shoulder, with marked tenderness at the proximal humerus. This is a distinctive sign of a non-displaced fracture of the proximal humerus in children. In adults, traumatic shoulder immobility has a clear history of injury, sudden onset, and localized tenderness, making it distinguishable from immobility due to arthralgia, frozen shoulder, or thoracic obstruction. For injury-induced static blood accumulation, treatment focuses on Origin-Restoring Blood-Invigorating Decoction or Seven-Li-Weight Powder to invigorate blood, resolve stasis, and relieve pain. For children, especially those aged 5–7, sudden inability to lift the arm—often unnoticed until dressing or undressing—with pain upon forced passive lifting and reliance on torso swaying to "swing up" the limb, is typical. Local swelling is minimal, but tenderness at the proximal humerus is present. This results from a non-displaced fracture due to a fall or trauma. Massage (tuina) must be avoided. Instead, protect the limb by slinging it in front of the chest with a bandage; natural recovery occurs within a month.

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1. Zhenjiu Zisheng Jing: Shoulder not lifting "Frequently seen in apoplexy patients, arm bone dislocation disease, not connected to the shoulder, many cases are not cured."
2. Linzheng Zhinan Yi'an: "The decline of the Yangming meridian, shoulder blade tendons slack, not lifting and painful. Treatment should focus on unblocking the meridians, do not attack wind. Use Astragalus Root, Atractylodes, Chinese Angelica, Saposhnikovia Root, Turmeric, mulberry twig."