Other Diseases

　　The causes of shoulder periarthritis are various. There are mainly two kinds of pathogenic factors: external causes and internal causes. Let's explain them in detail below:

　　1. Internal factors

　　Mainly due to insufficient Qi and blood. This disease mainly occurs in middle-aged and elderly people aged 40 to 50, who often have weak physique, deficiency of liver and kidney essence, nourishment loss of tendons, and pain due to blood deficiency. Over time, tendons and meridians become rigid and unusable. At this time, the speed of blood circulation slows down, and Qi and blood stagnation is prone to the formation of shoulder periarthritis.

　　2. External factors

　　External factors have a significant impact on the occurrence and development of shoulder periarthritis.

　　(1) Acute injury and chronic strain

　　This disease often occurs in middle-aged and elderly people over 40 years old. Due to the structural characteristics of the shoulder joint, it is flexible but lacks stability. Therefore, when suddenly injured by external force, the surrounding tissues of the shoulder joint are more prone to injury. Local ligaments and muscles may tear. There is often fluid exudation under the skin at the injury site, resulting in local swelling. If this period is not treated in time, excessive fluid that is not timely eliminated will form calcium deposits locally. This causes the surrounding soft tissues to become stiff, affecting local blood circulation. Many small granulation tissues are formed at the damaged site of the soft tissue, promoting adhesion of the soft tissue, and forming this disease.

　　(2) Influence of wind, cold, and dampness

　　With the change of seasons, the shoulder joint may be attacked by wind, cold, and dampness. This can cause obstruction of the meridians around the shoulder joint, leading to stiffness and adhesion of the tendons and muscles due to Qi and blood deficiency. The function is gradually restricted or lost, forming this disease.

　　(3) Other factors

　　Fractures of the clavicle or humerus caused by trauma. If the reduction and fixation time is too long, the shoulder joint does not receive movement for a long time, causing the tendons to lose nutrition and the Qi and blood to be blocked, which can also lead to shoulder periarthritis.

　　In addition, the lesions of some adjacent organs to the shoulder joint can also affect the surrounding blood circulation, causing aseptic inflammation of the soft tissues. Muscles and ligaments become stiff, the range of motion of the shoulder joint gradually decreases, and finally, soft tissue adhesions form, leading to shoulder periarthritis.

　　Many people think that shoulder periarthritis is just shoulder pain and limited range of motion of the shoulder joint, so the harm is not great. In fact, shoulder periarthritis, in addition to its own harm, can also cause some complications.

　　1. Impact on bursae

　　For example, the subacromial bursa, the subdeltoid bursa, the coracoid bursa, and the subscapularis, pectoralis major muscles, and other bursae on both sides of the intertubercular groove between the greater and lesser tuberosities of the humerus. These bursae are prone to be compressed and collided during shoulder joint movement, and their tendons also stimulate the bursae when the shoulder joint moves frequently. The accumulated wear and stimulation over time will affect their lubrication mechanism, eventually developing into chronic aseptic inflammation.

　　2. Impact on muscles

　　There are many and concentrated muscle stress points around the shoulder joint, forming a cap-like shape, such as the coracoid process for the short head of the biceps brachii, the attachment point of the pectoralis minor, the greater tuberosity of the humerus for the subscapularis, supraspinatus, infraspinatus, and teres minor muscles. These areas are prone to be affected by excessive external force, leading to tearing or cumulative fatigue injury and变性, ultimately causing aseptic inflammation.

　　3. Impact on bone and joint

　　These bone and joint structures mainly rely on the surrounding ligaments, tendons, and muscles, etc., soft tissues to maintain their stability and overcome the gravity of the upper limb. Due to the unstable structure of the bone and joint, the surrounding soft tissues are easily pulled and injured when subjected to excessive external force.

　　4. Impact on joint function

　　The range of activities is large and frequent, coordination of movements is constantly present in daily life and work, such as brushing teeth, washing face, combing hair, etc. The soft tissues of the shoulder bear the main weight. When writing, it appears that the shoulder and arm movements are not obvious, but in fact, various muscle groups of the shoulder still bear different stretching, flexing, and rotating coordination movements. These endless and frequent movements inevitably lead to the injury or fatigue of the soft tissues of the shoulder, and eventually cause aseptic inflammation.

　　The clinical manifestations of shoulder periarthritis involve pain around the shoulder, extending to the upper arm and forearm, and the pain worsens during movement. Severe cases may be too afraid to move the affected limb. During the acute stage, the pain is severe, and it is difficult to fall asleep at night. Initially, due to pain around the shoulder joint, local muscle spasms occur, limiting the movement of the shoulder joint, affecting daily activities such as dressing, washing face, and combing hair. Specifically, it can be summarized as follows:

　　(1) Shoulder pain

　　At first, the shoulder presents paroxysmal pain, most of which are chronic attacks. Later, the pain gradually intensifies or becomes acute, or it may be a cutting pain, which is persistent. The pain often worsens with changes in weather or fatigue. The pain can spread to the neck and upper limb (especially the elbow), and when the shoulder is accidentally bumped or pulled, it often causes a tearing pain. Shoulder pain being lighter during the day and worse at night is a major characteristic of this disease. Most patients often say they wake up in the middle of the night in pain and cannot fall asleep, especially not being able to lie on the affected side. This condition is more pronounced due to blood deficiency. If the pain is caused by cold, then the patient is particularly sensitive to changes in weather.

　　(2) Limited shoulder joint movement

　　The movement of the shoulder joint in all directions may be limited, especially in abduction, elevation, and internal and external rotation. With the progression of the disease, due to long-term disuse, the synovial sheath and soft tissues around the shoulder joint become adherent, the muscle strength gradually decreases, and factors such as the coracohumeral ligament fixed in a shortened internal rotation position, etc., limit the active and passive movement of the shoulder joint in all directions. When the shoulder joint is abducted, the typical 'shoulder bearing' phenomenon appears, especially when performing actions such as combing hair, dressing, washing face, and crossing the waist. In severe cases, the function of the elbow joint may also be affected, and the hand cannot touch the same side of the shoulder when flexing the elbow, especially when the arm is extended backward, it is not possible to complete the flexion action.

　　(3) Fear of cold

　　The affected shoulder is afraid of cold, and many patients wrap their shoulders with cotton pads all year round, even in summer, they dare not let the wind blow on the shoulder.

　　(4) Tenderness

　　Most patients can feel obvious tenderness points around the shoulder joint, with the tenderness points mostly located in the groove of the long head of the biceps brachii muscle. The bursal sac under the acromion, the coracoid process, the insertion point of the supraspinatus muscle, and especially the groove of the long head of the biceps brachii tendon are more pronounced. A few cases show widespread tenderness of the soft tissues around the shoulder, and it is rare to have no tenderness points.

　　(5) Muscle cramps and atrophy

　　In the early stage, muscles around the shoulder such as the deltoid and supraspinatus muscles may appear cramps, and in the late stage, disuse muscle atrophy may occur, with typical symptoms such as prominent acromion, difficulty in lifting the arms, and poor backward bending. At this time, the pain symptoms may even subside.

　　Shoulder periarthritis is more common in middle-aged and elderly people over 40 years old, and the main symptoms are pain around the shoulder, which affects the patient's daily life and work. Therefore, timely treatment is needed, and daily protection should be emphasized.

　　1. Pay attention to keeping warm

　　Due to the climate change in nature, cold and dampness constantly invade the body, causing muscle tissue and small blood vessels to contract. Prolonged contraction of muscles can produce more metabolic products, such as lactic acid and pain-causing substances, which accumulate and stimulate the muscle tissue, leading to cramps. Prolonged cramps can cause fibrous degeneration of muscle cells and dysfunction of muscle contraction, resulting in various symptoms. Therefore, it is important to pay attention to keeping warm in daily life, especially to avoid the shoulder from being cold, which is crucial for preventing shoulder periarthritis.

　　2. Strengthen functional exercises

　　For patients with shoulder periarthritis, it is especially important to pay attention to joint movement, and they can often practice Tai Chi, Tai Chi sword, boules, or perform exercises such as hanging the arms at home, using resistance bands, dumbbells, and hand swinging, but they should pay attention to not overexerting themselves to avoid causing injury to the shoulder joint and surrounding soft tissues.

　　3. Correct poor posture

　　Correct poor posture. For those who often work at a desk and have their shoulders frequently in an abducted position, attention should be paid to adjusting posture to avoid long-term poor posture causing chronic fatigue and cumulative injury.

　　4. Pay attention to related diseases

　　Pay attention to related diseases that can cause secondary shoulder periarthritis, such as diabetes, cervical spondylosis, shoulder and upper limb injuries, chest surgical operations, and neurological diseases. People with the aforementioned diseases should closely observe whether shoulder pain symptoms occur, whether the range of shoulder joint movement is reduced, and should carry out active and passive shoulder joint exercises to maintain the mobility of the shoulder joint.

　　Although the symptoms of shoulder periarthritis are obvious, diagnosis still requires auxiliary examinations. Shoulder periarthritis can be diagnosed by X-ray examination and shoulder arthrography.

　　1. X-ray examination:

　　Taking X-ray films is used as a means of differential diagnosis for diseases such as shoulder fractures, dislocations, tumors, tuberculosis, and osteoarthritis, as well as rheumatoid arthritis and rheumatoid arthritis. However, clinical findings show that about 1/3 of patients have different characteristic changes on X-ray films at different stages of shoulder periarthritis.

　　2. Shoulder arthrography:

　　Shoulder arthrography is a common examination method for shoulder periarthritis. It involves injecting contrast medium into the shoulder joint cavity and taking X-ray films to assist in the localization and diagnosis of shoulder diseases. After injecting the drug into the joint cavity, one should take an anterior and posterior standing shoulder joint internal and external rotation film with the central line tilted 20 degrees towards the head end, and one external rotation and abduction film with the central line tilted 10 degrees towards the fixed end. The film can show:

　　(1) The subscapular synovial sac has ruptured, and the leaked contrast medium mainly accumulates in the subscapular fossa, not extending beyond the rim of the glenoid cavity.

　　(2) The joint capsule has ruptured, and the contrast medium has leaked out from the rupture site, presenting as irregular patchy or bag-like shadows in the joint exterior and axillary fossa.

　　(3) The joint capsule has shrunk, with manifestations such as reduced joint capacity, a smaller or closed axillary recess, or the glenohumeral synovial sac or biceps brachii long head tendon sheath not being visible on imaging.

　　(4) The morphology, capacity, and surface morphology of the glenohumeral synovial sac, as well as the condition of the rotator cuff injury, can reliably reflect the condition of rotator cuff rupture and retraction of the distal ends.

　　Patients with shoulder periarthritis should choose their diet specifically to promote human disease and physical and mental recovery. Below, we will introduce the types of food that patients with shoulder periarthritis should eat.

　　1. It is advisable to supplement calcium.

　　Such as milk, eggs, dairy products, bone soup, black fungus, etc.

　　1. It is advisable to choose foods that tonify Qi and nourish blood, warm the meridians and dispel cold

　　Foods with astringent and nourishing properties, such as dog meat, beef, mutton, deer meat, ginger, chili, chive, walnut kernel, etc.

　　2. It is advisable to choose foods that tonify Qi and nourish blood, warm the meridians and dispel cold

　　3. It is advisable to choose foods that regulate Qi and blood, relax tendons and collaterals

　　Main foods such as corn, glutinous rice, side dishes such as Shanghui, luffa, rapeseed, watermelon seeds, sesame, mutton, pork kidney, chive, shrimp, walnut, black sesame, papaya, Danggui, etc.

　　Conventional methods of Western medicine for treating shoulder periarthritis

　　Shoulder periarthritis is also known as shoulder joint periarthritis, which is a common disease characterized by shoulder pain and limited movement. It can be treated with a comprehensive therapy of traditional Chinese medicine.

　　1. Traditional Chinese Medicine

　　Shoulder periarthritis should be treated in the early stage, and external application of Wujin plaster can be used to activate blood circulation and remove blood stasis, relax tendons and collaterals, and relieve inflammation and pain, thereby achieving the purpose of treating both symptoms and root causes. And pay attention to keeping warm and resting during the treatment period. Traditional Chinese medicine aims at removing wind and cold, relaxing tendons and collaterals, and promoting blood circulation and removing blood stasis.

　　2. Cupping

　　Cupping treatment for shoulder periarthritis commonly uses acupoints such as Ganshen, Yanyu, Qianjian, Yanzhen, Tianzong, etc. Select two acupoints each time, alternate use.

　　3. Scraping

　　Scraping treatment for shoulder periarthritis commonly uses meridians such as the Lung Meridian and the Large Intestine Meridian on the lateral side of the arm. It can be scraped 1-2 times a week.

　　4. Acupuncture

　　Acupuncture treatment for shoulder periarthritis commonly uses acupoints such as: Ganshen, Yanyu, Qianjian, Yanzhen, Dazhui, Quchi, Waiguan, Wangu, etc. Use 1-1.5 inch acupuncture needles, disinfect the skin with 75% alcohol cotton balls, insert into the acupoints, and leave the needle for 20-30 minutes. Once a day. Two weeks as a course of treatment.

　　5. Physical Therapy