Periarthritis of the shoulder

Periarthritis of the shoulder is a chronic specific inflammation of the shoulder joint capsule and its surrounding ligaments, tendons and bursae, mainly presenting as progressive shoulder pain that is worse at night and gradually intensifies, with progressively worsening limitation of shoulder movement, followed by gradual relief to eventual full recovery.

Common Symptoms

Impingement sign; postpartum neck and back soreness; shoulder pain; frozen shoulder; discomfort and soreness around the shoulder; scapular soreness; cold intolerance; limited shoulder movement; neck-shoulder fatigue and soft-tissue pain

Causes

It mostly occurs in middle-aged and elderly people over 40; degenerative changes of soft tissue and reduced ability to withstand external forces are the basic factors. Chronic injurious forces from long-term overactivity and poor posture are the main triggers. Prolonged immobilization of the shoulder after upper-limb trauma leads to secondary atrophy and adhesion of periarticular tissue. It also follows improper treatment of acute shoulder contusion and strain. Referred shoulder pain from cervical spondylosis and cardiac, pulmonary and biliary diseases, when the primary disease persists, causes sustained spasm and ischemia of shoulder muscles and forms inflammatory foci that turn into true periarthritis. It is divided into primary and secondary types. The shoulder has the widest range of motion of any joint; its capsule is loose and stability relies mostly on surrounding muscles, tendons and ligaments. Because the tendons have poor blood supply and undergo degenerative changes with age, and because the shoulder moves frequently in daily life while surrounding soft tissue is constantly rubbed and compressed, chronic strain easily develops and gradually forms primary periarthritis.

Treatment

Medication, supportive treatment, rehabilitation therapy

Prevention

Daily prevention of periarthritis: 1. Strengthening physical exercise is an effective way to prevent and treat it, but persistence is essential; without consistent exercise and rehabilitation, shoulder function is hard to restore. 2. Malnutrition causes weak constitution, which often leads to periarthritis; with adequate nutrition plus appropriate exercise, it often resolves without medication. 3. Cold exposure is a common trigger, so the elderly should keep warm and avoid chilling the shoulder, and treat any cold promptly without delay. 4. Strengthening shoulder muscle exercise prevents and delays periarthritis; surveys show that people with strong shoulder muscles have a much lower incidence, so strong periarticular ligaments and muscles are important for recovery. To prevent and treat it, one can hang from a horizontal bar (or similar bar) daily, or jog or crawl. An exercise regimen: standing, once each morning and evening; do all or selected as appropriate. 1. Active movement of the shoulder in all directions: forward elevation, extension, adduction, abduction, internal and external rotation, forward and backward rotation. 2. Bend forward 90 degrees at the waist, let the arms hang naturally, relax muscles, and swing the arms forward/back/left/right and in circles. 3. Bend the elbows to 90 degrees and shrug both shoulders from weak to strong, 50~100 times each time. 4. Bend forward, and use the affected forearm to reach downward as if scooping something, 30~50 times. 5. Face the wall with toes about 20~30 cm from it, let the affected fingers touch the wall and reach upward as high as possible, then return; turn 90 degrees in place and, with the affected side facing the wall, let the fingers reach upward along the wall as high as possible, then return. 6. Lean the arm against the wall, bend both elbows to 90 degrees, keep the upper arms close to the trunk and wall, palms up and outward/backward, use the thumb tips to touch the wall as far as possible, then turn palms down so the thumbs touch the upper abdomen. 7. Interlock both hands behind the back with elbows straight, use the healthy limb to pull the affected limb toward the healthy side, then return; then touch the lower back with both hands, bend the elbows, and move both thumbs upward along the back as high as possible, then return. Health education: 1. Periarticular shoulder lesions causing cervical-shoulder problems often lead to periarthritis; protect the cervical spine, use a pillow of appropriate height, avoid prolonged head-down posture, and do not sleep while riding. 4. There are many periarticular shoulder tissues; when there is pain or limited function, consult a doctor to identify the exact lesion and formulate corresponding treatment and rehabilitation. 5. Once periarthritis occurs, consistent functional rehabilitation exercise is essential.

Recommended Department

It is recommended to visit the orthopedic surgery department; before the visit you may first book an appointment and connect with experts through this platform.

Warm reminder: The above information is provided for health education reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek care at a regular hospital in time.