If I have frozen shoulder, can I shake my arm hard? The doctor refutes the rumors and takes you a comprehensive understanding of frozen shoulder

Periarthritis of the shoulder, this so-called diagnosis can really be said to be a household name

As long as someone talks about shoulder pain, someone around must say: You have a frozen shoulder, hurry up and shake your arm. You can dump it! They are so good! Is this really the case? Have you ever seen a patient who shakes his arm hard and finally breaks the tendon of his shoulder joint? Let's talk about it!

Frozen shoulder is the same diagnosis as synovitis. It can be said that it belongs to trash bin diagnosis . You can think of frozen shoulder and synovitis as a trash can. As long as there is pain in the knee or other joints, you can throw it in this bucket. As long as the shoulder is painful, you can also throw it in this bucket. When you tell patients that there is meniscus injury , cartilage injury , shoulder impingement syndrome, rotator sleeve injury , all patients will ask, that It's not frozen shoulder or synovitis, these two diseases are terrible , I don't know if the other diagnoses mentioned by the doctor are really troublesome!

Shoulder joints have only frozen shoulder disease. Isn’t it too childish?

Our shoulder joint is the most flexible joint on the body, it can almost complete 360-degree rotation, and it is very important for us to complete a lot of flexible upper limb exercises, so flexible shoulder joint, the surrounding must Abundant muscles, tendons, and ligaments, to maintain its stability , so that the shoulder can not be dislocated when doing flexible exercises. Therefore, the structure of the shoulder joint is particularly complicated, and the research on the shoulder joint has never stopped, and new understandings and ideas emerge every year.

Everyone can imagine that for such a complicated shoulder joint, as long as there is a problem, it must be caused by frozen shoulder. Isn't this kind of ridiculous? Moreover, if there is a problem with the shoulder joint, it must be frozen shoulder, which can be cured by shaking the arm hard. Is this treatment method a bit too simple?

So what kind of disease is the so-called frozen shoulder in our mouths?

In fact, the real frozen shoulder, it has a professional name called shoulder joint bursitis, also called 50肩,冻肩. The main pathological change of this disease is that the capsule around the shoulder joint of has aseptic inflammation. will gradually exudate and release inflammatory factors, which will cause the patient to have shoulder pain and slowly the entire shoulder joint. The sac of shrinkage , that is, becomes tighter and tighter, and the range of movement of the shoulder joint will become more and more limited. The characteristic of is that it has a certain degree of self-limiting. That is to say, even if it is not treated, it will be better slowly, and slowly the function of the shoulder joint of the patient will be restored, and the range of motion will gradually increase, and finally return to normal, which is like the shoulder joint is frozen Lived and thaw, so the most commonly used name should be 冻肩. So how long does it take for a patient's shoulder joint to thaw on its own? Everyone is different. Some people will recover slowly in 3 to 6 months, and some may last for more than three years.

● So why do you suffer from this disease? Although we were performing surgery on the patient, we found that the entire pathological changes of the patient’s joints were extremely extensive, and the patient’s shoulder joint capsule became compact and covered with newly formed synovium and proliferated blood vessels, so The entire joint cavity is narrow and blood-red , but why such a change occurs is not very clear. But we know what kind of people are more prone to this kind of problem. Generally is over 50 years old, and people with hypertension, coronary heart disease, diabetes and thyroid disease are more likely to have frozen shoulder , especially for diabetic patients, in Shoulder periarthritis nearly 30% of patients have abnormal blood sugar .

● Frozen shoulder will be relieved if it is not treated. It is self-limiting, shouldn’t it be treated? ? If you have never suffered from frozen shoulder, friends who have not suffered this sin, hearing the three words of self-limitation may think this way, that is, it is good without treatment and does not need treatment. But can only know how much it suffers from this disease. In the acute phase of frozen shoulder, the pain of the patient is particularly obvious. A slight movement of the shoulder joint will induce pain, especially during sleep. It can be said that many people The tortured person could not sleep for the whole night, sometimes fell asleep, turned over a little, and the arm was slightly moved, and then woke up with pain. After , it was difficult to fall asleep.

When slowly entering the freezing period, the adhesion of the shoulder joint is particularly serious, and all the activities of the shoulder joint will induce pain. patients comb their hair and lift their pants. 、To go to the toilet is very laborious , especially the right-handed patients have a frozen shoulder on the right side. Friends who don’t understand can imagine which side of the shoulder joint they can do, and they can’t do anything, just move it. Pain, can you suffer this sin?

In addition, there are some patients with particularly severe adhesions. After entering the defrosting period, the pain can be said to disappear, and the scope of the shoulder joint has also expanded to a certain extent, but due to the serious condition, the range of movement of the shoulder joint has been significantly reduced. , Which means that some functional obstacles are left.

If the above problems occur, should we just let them go and not give them treatment? Let the patient persist in the pain, persist in enduring, and look forward to the relief or disappearance of the pain that does not know when?

This is so inhumane!

I got a frozen shoulder, what should I do?

In fact, when it comes to treating , the most important thing is to make a clear diagnosis . If there is painful movement of the shoulder joint, the scope is obviously limited. The most basic thing is to go to the hospital for x-ray examination , clarify whether there is severe bone hyperplasia in the shoulder joint, whether there is abnormal calcification in the shoulder joint, if possible, a nuclear magnetic examination of the shoulder joint should be performed to determine whether there is rotator cuff injury, whether it is caused by other in the shoulder joint The disease caused the patient to have shoulder pain. makes a clear diagnosis and avoids misdiagnosis and mistreatment is very important. . During the shoulder joint X-ray and shoulder MRI examination, patients with frozen shoulder often have obvious changes in the position of the shoulder joint, which can still be identified.

Then when the frozen shoulder clearly appears, the treatment plan mainly includes the following aspects:

● analgesic : When the frozen shoulder occurs, pain is really the biggest trouble , Even if the range of motion of the shoulder joint is limited, if it does not hurt, the acceptance will be stronger, so it is very important to control the pain. Because the shoulder joint pain is particularly severe when frozen shoulders appear, oral and topical medications are recommended.

• Oral non-steroidal anti-inflammatory drugs : Commonly used are loxoprofen sodium, diclofenac sodium, celecoxib and so on. If you have gastric mucosal problems, or patients with gastric ulcers, you should carefully take loxoprofen sodium and other drugs, which may aggravate gastric problems and cause stomach bleeding. Analgesia can choose celecoxib, etc. Drugs that irritate the gastric mucosa relatively little If patients are in the anticoagulation stage of cardiovascular interventional therapy, such as taking clopidogrel or other drugs by mouth, they must be taken with caution.
• Flurbiprofen gel ointment is recommended for external use. This medicine has a very good effect on controlling shoulder joint pain, and it is rarely allergic because its composition is relatively single. It is a kind of cold patch. When using this drug, the pain will be slightly worse within two hours, but it will not last too long, and it will feel cold after applying this drug. , This is also normal.
• such asIf oral and topical medications still can’t relieve the symptom pain or even worsen, then you can consider shoulder joint closure treatment , giving anesthetics and a small amount of hormone injections into the shoulder joint, which can not only help patients control pain, It can also play a role in controlling inflammation and reaction. Generally, an injection is given in 10 to 14 days, and 2 to 3 times is a course of treatment. It should be emphasized here that if you have diabetes, you must control your blood sugar at around 7~8 before you can consider this treatment .

●Shoulder joint adhesion loosening : Patients with frozen shoulders have a limited range of adhesion activities. There are two main reasons, one is Because of the pain , the patient does not dare to move, and the shoulder joints will stick after a long time. Another aspect of is the disease itself. As mentioned earlier, freezing the shoulder will cause the shoulder joint capsule to shrink, which is serious. Affect the patient's shoulder joint function .

So if you want to control the adhesion at this time, no longer let the adhesion continue to aggravate, and slowly restore the angle of shoulder joint movement, you need two measures. One is self-active exercise. The other is passive rehabilitation exercise .

• Passive rehabilitation exercise is preferred : Why is passive rehabilitation exercise preferred? Because the rehabilitation exercise of the shoulder joint is not so simple, is best to first seek professional 修师 or the help of a rehabilitation therapist, Early, how to apply hot compress before rehabilitation exercise ，How to apply cold compress after rehabilitation exercise? What details should be paid attention to in the process of rehabilitation exercise? Ask the rehabilitation teacher or rehabilitation therapist for these details to better understand how to do rehabilitation exercises, so that you can lay a good foundation for your future active rehabilitation exercises. This time is not too long. Long, one month is enough. Although this stage will cost a certain amount of money, the things learned are very useful. This passive rehabilitation exercise technique is called Shoulder Joint Loosening Surgery. Relevant professionals can be found in the rehabilitation department of major hospitals or in rehabilitation physiotherapy department.

• Self-rehabilitation exercise: After mastering the relevant knowledge of rehabilitation exercise, you can perform self-rehabilitation exercise at home, and gradually restore the range of movement of the shoulder joint from multiple angles, slowly The pain will be significantly reduced and the range of motion will gradually recover. The following are 5 very commonly used rehabilitation exercise methods. Patients with shoulder pain can try to exercise. Pay attention to step by step. The number of exercises and the number of groups should increase slowly. Do not force .

a7#da#58805 Content : Why is it not recommended for patients with frozen shoulders to stand and shake their arms? This is the subject of our article. Why not suggest it? This is mainly because each of us has different shoulder joint conditions. There are some patients with frozen shoulders, and there are also severe shoulder joint impacts . This impact does not mean that the shoulder joint has been traumatized, but that has a congenital acromion shape that is curved or hook-shaped . In addition, some patients use the shoulder joint all the year round. Osteoarthritis has changed, and osteophyte (骨刺, bone hyperplasia) appears. These bone spurs make the acromion slowly appear in a hook-shaped state, so stand and shake the shoulder excessively It may cause tearing of the rotator cuff.

• What is the shoulder peak? The acromion of the shoulder joint is actually a structure of the scapula, which is a bit similar to the top of the shoulder joint. If we regard the shoulder joint as a house, the acromion is the roof and eaves!

• How to judge whether the acromion has morphological abnormality ? A simple X-ray film is fine, but this X-ray film is more specifically called the supraspinatus exit position of the shoulder joint, also called the Y position. In the initial stage of shoulder joint pain diagnosis of , you can communicate with the doctor. The examination of this film, can directly determine whether there is a shoulder joint impact. Of course, nuclear magnetic examination can also find this problem.

• Why is it not recommended to stand and shake your shoulders if you have a shoulder joint ? Because once the acromion appears hooked, when the shoulder joint is shaken vigorously, there may be an impact between the shoulder joint 肩峰 and the greater tuberosity of the humerus , there is no empty field between the two There is also an important structure in it called Rotator sleeve. It is a joint tendon composed of 4 tendons. With its existence, our shoulder joints can rotate, flex and extend very freely. Actions such as outreach and adduction! long-term impact will tear rotator cuff , which is like biting a piece of meat with two teeth, even if this piece of meat is strong, it will be bitten off sooner or later. , and once the rotator cuff occurs After a tear, the patient's shoulder joint function will be severely impaired, and the adhesion will become heavier.

• Does it mean that I can’t shake my shoulders? ? How can the range of movement of the shoulder joint be slowly developed? The answer is simple, just change the way of shaking , we can shake our shoulders, but instead of standing up, we have to bend down, like the picture below. In this way, the impact of the shoulder joint can be avoided to prevent the rotator cuff from being irritated to the possibility of tearing, and the purpose of increasing the range of motion of the shoulder joint is also achieved. This is very important. If you read this article, please tell patients with shoulder pain or patients with frozen shoulders, don’t stand and shake your shoulders and bend your waist .

Summary

For patients with frozen shoulders, do not stand and shake their shoulders, If you can’t control the pain and don’t know whether there is a shoulder joint impact, force this shoulder swing , not only will aggravate the patient’s pain, but also a rotator cuff tear may occur.

Some patients will definitely say when they see this place, then so-and-so and so-and-so by my side are shaking their shoulders hard, and the function of shaking them back to normal in a few days!

This is typical survivor logic . For this kind of crowd, he only saw the good people around him, but he didn't see the rotator cuff in the hospital because of a large number of shoulder throws. In the end, surgery is necessary to solve the problem, and for the so-called dumped patients of , it is not known whether the shoulder is frozen or not, and whether there is a shoulder impact is also unknown. , just through the side I have seen some special cases, and it is assumed that everyone can get rid of it. This is the typical survivor logic, which can be said to be rather absurd. To be honest, most people can meet a few patients with frozen shoulders, but as a doctor, you can meet dozens of patients with shoulder pain in one month. Who can have a professional doctor has a better say What? Don't say this answer!

How to treat patients with frozen shoulder? This article on how to rehabilitate and exercise is here for everyone. If you have other doubts, you can leave a message below and discuss it together.

I am Xie Xinhui, who insists on explaining complex disease knowledge in simple language. The code word is not easy, such asIf you agree with my point of view, please help me to follow or like it. If you or your family and friends are also troubled by frozen shoulders, please forward this article to them who need it and tell them all Don't shake your shoulders casually, it may get worse! Thank you!

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(This article does not have any diagnostic value, and if there is any problem, it is recommended to go to the local hospital for interview Diagnosis, some pictures are from the Internet, infringement deleted!)