"Director Bi, I don't feel any pain at all now! I almost got a knife. Show me my sisters, and they both said that their shoulders hurt." Recently, Aunt Zhang (pseudonym), who is over 50 years old, made a special trip to Bi Qing's clinic of Zhejiang Provincial People's Hospital, and kept thanking him.
"50 shoulder " need surgery? A little panicked
One morning half a year ago, the first patient Bi Qing treated was Aunt Zhang, and her "weird" posture was particularly conspicuous in the waiting area. "At that time, her right upper arm was carefully supported with her left hand. When she did physical examination, she moved her shoulder joint slightly. She immediately screamed and her whole body was trembling. To borrow the words of her daughter, it was really 'ache of emoticons'!" Bi Qing recalled the scene when Aunt Zhang visited the doctor and was very impressed.
"I have seen shoulder pain in . I went to four or five hospitals in a row, and the doctors suggested surgery immediately." Because I was afraid of the operation and thought about it, Aunt Zhang decided to go to Bi Qing to take a look, "If you also recommend surgery, I will admit it." From Aunt Zhang's magnetic resonance and CT results, combined with Aunt Zhang's age, considering that there is no history of trauma, the tendon edema adhesion is more obvious, but there is no obvious tear, Bi Qing considers idiopathic shoulder adhesions without obvious causes - mainly occurring in middle-aged and elderly people aged 40-70, among which it is more common in the age of 50, which is often called "fifty shoulders".
patients with pain first, especially in the middle of the night, which is very sensitive and cannot fall asleep; secondly, joint movement is limited and can't even move, and it hurts as soon as you move. Especially after about one month of onset, the pain symptoms are particularly obvious, causing patients to seek frequent medical treatment.
Bi Qing said that this type of disease is not complicated, but the current treatment methods are "various". Some people immediately require surgery, some advocate acupuncture and massage in traditional Chinese medicine, some advocate relaxation of techniques, etc. Patients are often at a loss.
Conservative treatment without surgery can be
Aunt Zhang's right shoulder joint has a manifestation of acromion impact, but not heavy; rotator cuff tissue and sac, there is obvious edema in the position of the humeral head, and a little osteoporosis , which is the typical "fifty shoulder". "We generally do not choose surgical treatment without obvious structural damage and other lesions." Bi Qing, who has more than 20 years of experience in shoulder joint treatment, prescribed an Aunt Zhang:
- relieves pain through taking drugs, local closed injections, physical therapy, etc., and gradually restores shoulder joint mobility by using appropriate joint traction and other training. It cannot be too rushed.
- Before going to bed at night, use hot water to rinse the shoulder joints for up to 10-15 minutes each time until the entire shoulder and back are hot and red, and then the appropriate amount of exercise is 2-3 minutes to fall asleep to relieve night pain.
- Try to eat less spicy food , drink less alcohol and don’t smoke. You can run, walk briskly and other exercises. Rinse it with hot water after exercise and don’t catch a cold.
"It really doesn't require surgery, it's great!" Bi Qing injected Aunt Zhang's joint cavity with drugs to reduce swelling and relieve pain, and combined with oral medications, hot compresses, physical therapy and limited functional activities and other treatments. Bi Qing instructed Aunt Zhang to come to the outpatient clinic for a regular follow-up examination twice a month, and the pain would be relieved after two to three months. "Director Bi was too accurate. The pain was not relieved significantly at the beginning. I insisted and it started to get better in about 3 months." At present, Aunt Zhang's shoulder pain has been cured, and her arms can be lifted flexibly, and she has returned to her normal life.
Remember! Surgical treatment is not necessarily the preferred option
Bi Qing said that as long-term activity gradually develops acromional bone hyperplasia, osteophyte formation of large humeral tuberculosis, acromary joint hyperplasia, and hyperplasia of acromional joint, causing stenosis of the subacromational gap in , thereby causing squeezing and impact of the subacromational structure.
(Bi Qing data photo)
When the patient often performs postures and movements of shoulder joint abduction, external rotation, and internal rotation, such as taking a bus to pull the ring, stir-fry and cut vegetables, the acromion will be like a bird's beak pecking, repeatedly impacting the tendons and burses in the subacromum space. Suddenly, the strength increases again or is accidentally injured, congestion, edema, degeneration, and even tendon rupture will occur. Typical manifestations are dull pain on the shoulders, some are only slightly sore at the beginning, while others are severely painful at the beginning.
Many people immediately think of going to massage, massage, relaxation, etc. when they have pain, and they must continue to work. In fact, for early pain, the most reasonable method is to take a 2-week rest to reduce influencing factors, hot compress, oral anti-inflammatory and analgesic drugs, joint injection drugs, etc. Many symptoms can be effectively controlled. For some patients with idiopathic shoulder pain, it is often related to insomnia, anxiety, and low immune function, and these factors should also be intervened in advance. However, if the condition does not improve significantly after 6 months of the above conservative treatment and shoulder dysfunction seriously affects life and workers, surgical treatment needs to be considered.
Finally, Bi Qing emphasized: The causes of shoulder pain in middle-aged and elderly people are complex, and the causes of supraspinatus injury to rotator cuff tissue are the most common. What kind of treatment should be chosen to be the most satisfactory and the most accurate effect? It is still necessary for experts to make decisions after individualized evaluation of the patients.
Correspondent: Yang Taoyu Lin Yangqing
Reporter: Wang Xin
