Jipeng Song, MD, Spine Surgeon, Beijing Shijitan Hospital Affiliated to Capital Medical University
With the increase of age, many middle-aged and elderly friends will have symptoms of shoulder pain and discomfort. At this time, someone will tell you, do you have frozen shoulder? In fact, the term frozen shoulder is no longer commonly used in the work of professional orthopaedic doctors, and is replaced by more accurate diagnosis, such as shoulder impingement syndrome, frozen shoulder, biceps long head tenosynovitis, etc.
What are the symptoms of shoulder impingement syndrome?
According to the analysis of clinical sample data, the causes of pain and limited mobility around the shoulder mainly include shoulder impingement syndrome, supraspinatus tendon calcification, biceps tendonitis, frozen shoulder and subacromial bursa inflammation. We mainly talk about the common shoulder impingement syndrome. Since it is called a syndrome, it refers to the symptoms caused by a series of diseases. It is called a syndrome. The common clinical feature is that the active movement of the shoulder is limited, accompanied by pain arc , If the arm is raised to a certain extent, the pain begins, and the pain disappears after this range. , However, the pain in the shoulder will be less at night than during the day.
How is “shoulder impingement syndrome” diagnosed?
To diagnose shoulder impingement syndrome, in addition to the above symptoms of pain and activity limitation, it is also necessary to cooperate with auxiliary examinations. In the past, plain X-ray films were relied on. Although many patients had no positive findings on plain films, the main manifestation was the humerus. Greater tubercle sclerosis, osteophyte formation. At present, the development of MRI technology mainly relies on the diagnosis of MRI to find the specific location of inflammation and edema. In this way, clinical symptoms and MRI examination results can accurately diagnose shoulder impingement syndrome.
What should I do if I have shoulder impingement syndrome?
First immobilize in the acute stage, the pain is self-protection and avoid activities, rest, use a triangular towel to suspend the upper limbs, so that the ligaments of the shoulder joint can be relaxed, or local pain points can be treated with closed injection of drugs, oral anti-inflammatory Painkillers.
After the acute stage, it is necessary to start functional exercises on the shoulder joint. The degree of activity should be such that it does not cause shoulder pain. No pain means that no impact occurs. The active exercise of the shoulder joint mainly includes three directions of movement, front and rear, abduction and adduction and rotation. If it doesn’t get better through conservative treatment, then don’t worry, the current surgical treatment technology is very mature. Mainly for patients who have been ineffective after long-term conservative treatment. Therefore, once suspicious symptoms of shoulder impingement syndrome appear, seek medical treatment as soon as possible, and receive active treatment. The vast majority of early patients do not need surgery.
Why does impingement syndrome occur?
The anatomical structure of the acromion is narrow in the front and wide in the back, so the injury mainly occurs in the front and middle. The injury process is roughly divided into three stages. The first stage of the early acute stage is mainly edema, and there is no rotator cuff tear, so no surgical treatment is required. In the second stage, due to repeated impact injuries, the rotator cuff and other components continue to undergo fibrosis. At this time, some patients need to surgically remove the hyperplastic and thickened tissue. The most serious third stage refers to the fact that no treatment was received in the second stage, and the thickened tissue began to calcify, or ossification. At this time, acromoplasty was performed. The main pathological changes in these three stages are: inflammation and edema – fibrosis and thickening – ossification and calcification. Therefore, once symptoms appear, they must be actively treated as soon as possible, so that they will not develop later.