Etiology
Frozen shoulder is a condition that causes loss of motion and painful shoulder in the shoulder joint due to peri-shoulder joint soft tissue inflammation. The causes of Frozen shoulder are as follows:
o Degenerative arthritis
o Injury/surgery/fracture in shoulder or arm
o Hormone Changes (hyperthyroidism or estrogen)
o Diabetes
o Cervical disk or vertebrae foramen diseases
o Heart/ circulatory diseases
o Exposure to cold & dampness
o Cholecystitis or pneumonia
o Pathologic changes in frozen shoulder: Inflammation, contraction, adhesion and calcification.
Clinical Features
Frozen shoulder is characterized by a decreased range of motion, primarily seen in lifting (extension of) the arm and turning it inwards to reach back or outward(medial and lateral rotation). Frozen shoulder is most common in the 40 – 60 year old age group, it is therefore called fifty shoulder, and it is twice as common in women as men. Depalma (1983) categorized frozen shoulder symptoms into three phases.
o Acute phase that is characterized by significant pain, difficulty sleeping and significant functional impairment.
o Progressive stiffening phase when the shoulder motion worsens.
o Resolution or thawing phase identified by the gradual return of both motion and function.
Diagnosis
o Middle age person, especially around age 50, with one shoulder pain without obvious injury, limited range of motion and progressively worsening.
o Pain on pressure mainly in great tubercle of humerus, intertuberclar groove and acromion.
o Limited range of motion of extension and rotation, especially medial rotation to reach the back.
o X-ray no abnormalities.
o The overall course is variable but can last 12 – 36 months.
Traditional Chinese Medicine differentiates frozen shoulder symptoms into three types:
o Wind cold dampness, the most common type
o Blood stasis
o Deficiency
Differentiation
o Cervicalopathy
o Neck & shoulder fasciatis
o Rheumatic Arthritis
o Supurative shoulder arthritis
o Shoulder TB
o Shoulder and soft tissue injuries
o Rotator cuff tendonitis
Treatment of Frozen Shoulder
First phase of frozen shoulder treatment: Herbal medicine therapy, our Frozen Shoulder Herbal Formula un-freezes the shoulder by eliminating the damp cold, increasing blood circulation and decreasing the inflammation. After taking Frozen Shoulder Herbal Formula, 50% of the patients experience improvement within one week, 75% within two weeks and 85% within three weeks.
Second phase: Frozen Shoulder Herbal Formula, acupuncture with electrical stimuli and Tuina manipulation stage.
Third phase: acupuncture with Tuina and Qi Gong Frozen Shoulder Exercises.