Frozen Shoulder | 肩周炎

Frozen shoulder


Frozen shoulder, also called adhesive capsulitis, means your shoulder is painful and stiff for months, sometimes years. Over time, the shoulder becomes very hard to move.

If you have frozen shoulder, you’ll likely feel a dull or achy pain in one shoulder. You might also feel the pain in the shoulder muscles that wrap around the top of your arm. You might feel the same sensation in your upper arm. Your pain could get worse at night, which can make it hard to sleep. The hallmark signs of this condition are severe pain and being unable to move your shoulder.


Frozen shoulder happens more often in women than men, and you’re more likely to get it if you’re between the ages of 40 and 60. Your risk might also go up if you’re in the process of recovering from a medical condition like a stroke, or surgery like a mastectomy that keeps you from moving your arm. Certain medical conditions can increase your risk too. You may also be more likely to get frozen shoulder if you have diabetes. Other medical problems like heart disease, thyroid disease, or Parkinson’s disease are linked to frozen shoulder, too.


In Traditional Chinese Medicine (TCM), frozen should is belong to “BI-Syndrome”. it is mainly related to deficiency of Qi & Blood, invasion of external Wind, Damp, Heat and Cold pathogens, and traumatic strain.


TCM Treatment:

The treatment principle is promoting Blood, unblock meridians, relaxing muscle and relieving pain. We may use acupuncture, cupping, Chinese herbal medicine, Tui-Na (massage) to treat.

1, Acupucnture (and Cupping):

Acupuncture can help in the treatment of frozen shoulder, by:

  • Stimulating nerves located in muscles and other tissues, which leads to release of endorphins and other neurohumoral factors, and changes the processing of pain in the brain and spinal cord (Pomeranz, 1987, Zijlstra 2003, Zhao 2008, Cheng 2009);

  • Reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kim 2008, Kavoussi 2007, Zijlstra 2003);

  • Enhancing local microcirculation, by increasing the diameter and blood flow velocity of peripheral arterioles (Komori 2009).

  • One research shows, acupuncture causes improvement of all movements of the shoulder, but about flexion and abduction the improvement was evaluated to be more. (M Asheghan, etc. 2016)

Commonly used acupoints for frozen shoulder are: LI 14, LI 15, SI 9, SJ 14, GB 21, Jianqian (EX-UE12), etc.


2, Chinese herbal medicine:

For decocting and drinking, with the treatment principles of dispelling wind and cold, relieving spasms and pain, unblock ing the meridians, and promoting blood circulation, the commonly used formulas are: "San Bi Tang" and "Shen Tong Zhu Yu Tang",etc.


3, Tui-Na (Massage):

Mainly use Tui-Na manipulations such as "rolling, kneading, pulling, shaking, rubbing", which can relax muscles, remove blood stasis, relieve spasm and pain, improve local blood circulation, loosen adhesions, smooth joints, and promote and restore shoulders Joint functional activities.

4, MOXA and herbal heat patch:

The main function is to dispel the cold and dampness, remove blood stasis to unblock the meridians, and relieve pain.


Prevention:

1, Avoiding cold and keeping warm

Cold and dampness constantly invade the body, it can cause muscle tissue and small blood vessels to contract, muscle tissue is stimulated and spasm occurs, which aggravates the pain and prolongs the course of the disease. Therefore, it is very important to prevent frozen shoulders in daily life, especially to avoid cold.

2, Exercise

For frozen shoulders, joints exercises are very important. You can often practice Tai Ji, or perform other exercises such as hanging arms, swinging hands, scorpion climbing walls, and pulling hands behind the body at home. But it should be done step by step to avoid the damage to the shoulder joint and soft tissues.


3, Correct posture

For those who do lots desk work, or always keep their shoulders in abduction position, they should adjust their postures to avoid joints damage caused by long-term bad postures.


The best way to prevent frozen shoulder is to avoid keeping your shoulder still for a long time. And get treatment as early as possible if you injure your shoulder or develop shoulder pain that limits your range of movement.


 

肩周炎

肩周炎又稱肩關節周圍炎。以肩部逐漸產生疼痛,夜間為甚,逐漸加重,肩關節活動功能受限而且日益加重,達到某種程度後逐漸緩解,直至最後完全復原為主要表現的肩關節囊及其周圍韌帶、肌腱和滑囊的慢性特異性炎症。臨床上患者多為50歲左右,故又稱為“五十肩”。由於疾病過程肩關節僵硬,活動明顯受限,又稱“凍結肩”“肩凝症”。由於常常肩部受涼而得或受涼疼痛加重,又稱“漏肩風”。這些名字能反應肩周炎的特徵。

肩周炎是以肩關節疼痛和活動不便為主要症狀的常見病症,中醫認為它主要與氣血不足、外感風濕寒邪、外傷勞損有關。三方面因素所致的肩部疼痛和關節活動障礙常可相互影響,初起時是因肩部痛甚而不敢活動,肩關節自然的採取保護性制動,而長期的製動使肩部血運不暢,以致軟組織發生粘連,使關節活動功能受限,強制活動則疼痛加劇,造成惡性循環。


治療

肩周炎屬中醫學的“痺證”範疇。治法宜活血通絡,宣痺止痛。中醫治療可用針灸、拔罐、內服中藥、推拿、熱敷等。

  • 針灸:對減輕或解除肩周炎的疼痛症狀療效較好,儘早治療不但可以減輕疼痛,而且可以加速恢復,縮短病程。常用穴位:肩髃、肩髎、肩貞、臂臑、肩前等。

  • 中藥:內服,以祛風散寒、解痙通絡,活血化淤為治療原則,“三痺湯”和“身痛逐瘀湯”加減。

  • 推拿:主要運用“滾、揉、搖、扳、抖、搓”等推拿手法法,能起到舒筋通絡,散瘀止痛,改善局部血液循環,解痙、松解粘連,滑利關節,促使肩關節功能活動恢復。

  • 艾灸,中藥熱敷:主要作用是散寒除濕,疏經通絡,能起到一定的緩解疼痛作用。

預防

1, 注意防寒保暖

由於自然界的氣候變化包括冷氣,寒冷濕氣不斷侵襲機體,可使肌肉組織和小血管收縮,肌肉組織受刺激而發生痙攣,使疼痛加重,病程延長。因此,在日常生活中註意防寒保暖,特別是避免肩部受涼,對於預防肩周炎十分重要。

2, 加強功能鍛煉

對肩周炎來說,特別要注重關節的運動,可經常打太極拳、太極劍,或在家裡進行雙臂懸吊、雙手擺動、蝎子爬牆、體後拉手等運動,但要注意運動量,以免造成肩關節及其周圍軟組織的損傷,應該循序漸進,幅度由小到大,動作由慢到快。

3, 糾正不良姿勢

對於經常伏案、雙肩經常處於外展工作的人,應注意調整姿勢,避免長期的不良姿勢造成慢性勞損和積累性損傷。

4, 飲食方面:

忌吃肥膩食品:肩周炎屬中醫的“痺證”。中醫認為,痺證主要是由於體內氣血痹阻不通所致,而高脂厚味的食物容易影響脾胃運化而生濕,濕屬陰邪,易加重氣血痹阻.




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