Periarthritis of the shoulder refers to a disease characterized by chronic injury or trauma to the soft tissues around the shoulder joint, resulting in degeneration and detachment of articular cartilage, as well as pathological changes such as atrophy of joint capsule, synovium, ligaments, and muscles. Main symptoms include shoulder pain, swelling, and restricted joint function. In Traditional Chinese Medicine, it is known as "Lòu Jiān Fēng" or "Frozen Shoulder."
Prevention before illness
Proper sleeping posture must be adopted. During sleep, the upper limb should be extended forward or slightly raised, avoiding pressure on the lower side of the body, especially in elderly people. After shoulder trauma, do not fix in the traditional position; instead, place the upper arm in a natural hanging, externally rotated position, preferably fixed in an abducted and elevated position.
If minor trauma occurs, keep the upper limb in an abducted and elevated position for rest, particularly after shoulder tearing, maintaining fixation for two weeks.
After shoulder trauma surgery, shorten the fixation period. Ideally, do not exceed three weeks to prevent disuse atrophy of muscles and soft tissues.
Avoid cold exposure and overwork.
II. Prevent progression after illness
Although the course of this condition is long, proper treatment leads to full recovery. If untreated early, shoulder pain worsens and functional impairment increases, eventually causing disuse atrophy of muscles and soft tissues around the shoulder joint.
(1) Chinese herbal steam washing method
Medicines: Astragalus membranaceus, Angelica sinensis, Ligusticum chuanxiong, Cinnamomum cassia twig, Schizonepeta tenuifolia, Saposhnikovia divaricata, Asarum heterotropoides, Morus alba branch, Epimedii Herba, Dictamnus dasycarpus, Sargentodoxa cuneata, Cinnamomum cassia, Bombyx mori, Gastrodia elata, Frankincense, Notopterygium franchetii.
Place the above herbs in a basin, add water to about half-full, boil for 20 minutes, then use a cloth soaked in the hot liquid to gently wipe and wash the shoulder joint. Avoid wind after washing. Wash once or twice daily. One dose lasts seven days; store the herb basin in a cool place after each use.
(2) Acupuncture
Acupoints: Jianyu (LI15), Jugu (GB21), Jianliao (SI14), Naoyu (SI13), Jianzhen (SI9), Quchi (LI11), Tiaokou (ST38), etc. Once daily or every other day.
(3) Massage and manipulation therapy
1. Acupoint kneading for tendon relaxation: Patient sits, upper limb muscles and joints relaxed. Practitioner stands beside, one hand holds the patient’s wrist, the other thumb moves from distal to proximal along the upper limb, stimulating acupoints to relieve tension.
2. Point pressure massage: Patient sits, shoulder muscles and ligaments relaxed. Practitioner stands beside, one hand presses above the tender point, the other rubs below it, both hands working together, gradually moving downward, repeated 5–10 times.
3. Axillary tendon relaxation: Patient sits, shoulder muscles relaxed. Practitioner stands beside, one hand grasps the patient’s upper limb, the other hand manipulates the major tendon under the armpit. Technique should be moderate, within tolerable limits.
4. Shoulder joint kneading: Patient sits, shoulder muscles relaxed. Practitioner stands beside, one hand holds the patient’s wrist, the other kneads the shoulder joint—first inner side, then outer side, followed by back of shoulder. Start light, gradually increase pressure.
5. Scapular pushing: Patient sits, hands on knees, back muscles relaxed. Practitioner stands behind, using both thumbs to push and press scapular muscles and joints, starting from the scapular border and moving downward gradually.
6. Axillary traction: Patient sits, shoulder muscles and joints relaxed. Practitioner stands beside, one hand pulls the patient’s wrist, the other hand clenched into a fist pushes against the armpit, coordinated and forceful movements.
7. Shoulder rotation (flexion and extension): Patient sits, shoulder and elbow muscles relaxed. Practitioner stands behind and to the side, one hand supports the shoulder joint, the other holds the elbow, repeatedly performing flexion and extension motions. Movements must be coordinated; avoid excessive force to prevent muscle strain.
8. Horizontal stretching: Patient sits, shoulder muscles relaxed. Practitioner stands behind and to the side, one hand pulls the wrist up and down to shake, the other pushes the shoulder, opposite forces applied.
Massage and manipulation help relax muscles, activate blood circulation, relieve spasm, reduce swelling, break adhesions, and improve joint mobility, thus achieving therapeutic goals.
Physical therapy such as ultrashort wave, infrared, spectrum instrument irradiation, wax ion introduction, etc.
Injection therapy: Inject 25 mg of prednisolone acetate plus 10 mL of 0.5% procaine at the painful site. Once per week.
Functional exercise: In addition to the above treatments, self-exercise is encouraged—actively perform rotational movements of the upper limb, raising, and backward extension exercises to promote early recovery.
<Periarthritis of the Shoulder>