Shoulder pain and discomfort
Introduction
Introduction Shoulder pain and shoulder discomfort is also known as the leaking shoulder wind, inflammation around the shoulder joints, fifty shoulders, and the shoulder joint dysfunction is also known as the frozen shoulder. Periarthritis of the shoulder is a common condition characterized by shoulder pain and inconvenient movement.
Cause
Cause
First, the cause of frozen shoulder:
Shoulder cause
1 Most of the diseases occur in middle-aged and elderly people over 40 years old. The soft tissue is regressed and changed, and the weakening of tolerance to various external forces is the basic factor.
2 Chronic injury caused by long-term excessive activity and poor posture is the main cause of stimulation.
3 After the upper limb trauma, the shoulder was fixed for too long, and the shoulder tissue was atrophied and adhered.
4 acute contusion of the shoulder, improper treatment due to improper treatment.
2. Outer shoulder factors
Cervical spondylosis, the shoulders involved in heart, lung and biliary tract diseases involve pain. The long-term unhealed primary disease causes the shoulder muscles to become persistent and paralyzed, forming an inflammatory lesion and transforming into true shoulder inflammation.
Second, the cause of cervical spondylosis: the basic pathological changes of cervical spondylosis is the degeneration of the intervertebral disc. The cervical vertebra is located between the skull and the thorax. The cervical disc has frequent activities under load-bearing conditions and is susceptible to excessive micro-injury and strain.
The main pathological changes are: early cervical disc degeneration, decreased water content of the nucleus pulposus and fibrous swelling and thickening of the annulus fibrosis, followed by glassy degeneration and even rupture. After cervical disc degeneration, the pressure resistance and tensile strength are reduced. When subjected to the gravity of the skull and the pulling force of the muscles of the head and chest, the degenerated disc can undergo localized or extensive bulging to the periphery, narrowing the intervertebral disc space, overlapping the articular processes, dislocation, and the longitudinal diameter of the intervertebral foramen. Become smaller. As the traction resistance of the intervertebral disc becomes weaker, when the cervical vertebra moves, the stability between adjacent vertebrae decreases and the intervertebral instability occurs, the mobility between the vertebral bodies increases and the vertebral body has a slight slippage, which then appears Bone hyperplasia of the posterior facet joint, hook joint and lamina, degeneration of the ligamentum flavum and ligament, cartilage and ossification.
Examine
an examination
Related inspection
Bone and joint soft tissue CT test buffer
1. Shoulder pain: At the beginning, the shoulders showed paroxysmal pain. Most of them were chronic attacks. Later, the pain gradually increased or pain, or the knife cut pain, and it was persistent. After climate change or fatigue, the pain often worsened. Pain can spread to the neck and upper limbs (especially the elbows). When the shoulder is accidentally bumped or pulled, it can often cause tearing pain. Shoulder pain, light night and heavy weight are a major feature of the disease, most patients I often complain that I wake up in the middle of the night and can't be awkward, especially if I can't lie on the side of the affected side. This situation is more obvious because of blood deficiency; if it is caused by cold, it is particularly sensitive to climate change.
2, shoulder joint activity is limited: shoulder joints can be restricted in all directions, outreach, lifting, internal and external rotation is more obvious, as the disease progresses, due to long-term disuse caused joint capsule and shoulder soft tissue adhesion, The gradual decline of muscle strength, coupled with the fixation of the patellar ligament in the shortened internal rotation position, limits the active and passive activities of the shoulder joint in all directions. When the shoulder joint is abducted, a typical "shoulder" phenomenon occurs, especially It is difficult to complete the movements such as combing, dressing, washing the face, and akimbo. In severe cases, the function of the elbow joint can also be affected. When the elbow is flexed, the hand cannot touch the shoulder of the same side, especially when the arm is extended.
3, afraid of cold: suffering from shoulders and cold, many patients wrap their shoulders with cotton pads all year round, even in the summer, the shoulders do not dare to blow.
4, tenderness: Most patients can touch the obvious tender points around the shoulder joints, and the tender points are mostly in the long head sulcus of the biceps. The shoulder peak sag, the condyle, the attachment point of the supraspinatus muscle.
5, muscle spasm and atrophy: deltoid muscle, supraspinatus muscle and other muscles around the shoulder can appear early, disuse of muscle atrophy in the late stage, the emergence of shoulder peaks, inconvenience, backward bending and other typical symptoms, pain at this time Symptoms are alleviated. The deltoid muscle has mild atrophy and trapezius muscle spasm. On-shoulder tendon, biceps brachii, short-head tendon and deltoid anterior and posterior margins can have significant tenderness. The extension of the shoulder joint, the external rotation, and the extension of the shoulder are the most obvious. A few people have limited internal and internal rotation, but less flexion.
6, X-ray and laboratory examination: regular radiography, mostly normal, some patients can see osteoporosis, but no bone destruction, can see calcification shadow under the shoulder. Laboratory tests are more normal. If the age is older or the course of disease is longer, X-ray plain film can be seen on the shoulder osteoporosis, or on the upper tendon and the scaphoid calcification.
Diagnosis
Differential diagnosis
1. Shoulder pain: Shoulder pain refers to pain in the muscles of the shoulders and shoulders and muscles around the shoulder blades. Among all the joints of the body, the shoulders may be the most versatile, and it has a lot of muscles and muscles, allowing your arms to do a wide range of activities, as well as the joints that are most prone to fatigue and disease. Many elderly people suffer from shoulder pain because of "shoulder periarthritis". After a long time, they are easy to form a mindset, thinking that shoulder pain must be a symptom of frozen shoulder. In fact, shoulder pain may also be caused by other more serious diseases.
2, severe shoulder pain: often caused by dislocation of the shoulder joint. There is a clear history of trauma.
3, shoulder involvement pain: due to visceral disease, causing shoulder pain, or hyperalgesia, known as suffering. Symptoms appear to be slow, dull, or uncomfortable. They do not completely conform to the nerve direction, the area is blurred, and the pain is blurred.
4, dull pain and radiation pain in the shoulder area: the dull pain and radiation pain in the shoulder area is the clinical manifestation of the suprascapular nerve compression syndrome. Scapular nerve compression is one of the most common causes of shoulder pain. Some scholars abroad believe that this sign accounts for 1% to 2% of all patients with shoulder pain.
