“冻结肩”，也成为粘连性关节炎（国内俗称肩周炎），发病后会出现肩关节疼痛和僵硬。可能会因为很小的损伤造成，但但多数没有明确的原因而出现。“冻结肩”也会和其他健康问题有关，比如糖尿病和甲状腺疾病。一旦患病，疼痛和僵硬会活动受限，诸如穿衣服、梳头或者够不到东西。有2%的人会在人的一生中某个时段出现，特别是40岁到65岁的人群中有5%的人会出现该疾病。出现后肩部问题会持续1到2年。患有“冻结肩”的病人最初会出现肩部的“休息痛”、活动时的“剧痛”以及因为疼痛导致的入睡困难。这些症状会逐渐导致活动丧失（因此成为冻结）和肩部的功能受限几个月，疼痛缓解后会导致活动更加困难。“冻结肩”的症状会自愈并且活动度和功能会逐渐改善。近期，专家们提出了一些列的提高冻结肩患者疗效的指南。这些指南发表在2013年的（J Orthop Sports Phys Ther）《骨科运动康复杂志》杂志。
Frozen shoulder, also known as adhesive capsulitis, refers to a condition where the shoulder becomes painful and stiff. It may occur following a relatively minor injury to the shoulder but most often develops without a clear reason. Frozen shoulder can also be linked to other health problems such as diabetes and thyroid disease. With this condition, the pain and stiffness can limit your ability to do simple everyday activities like getting dressed, brushing your hair, or reaching into a cabinet. The condition affects between 2% and 5% of the population at some point in their lives, and typically occurs in adults between 40 and 65 years of age. The problem usually lasts 1 to 2 years.
People with frozen shoulder usually experience an initial period characterized by an achy shoulder at rest, severe pain with move-ment, and difficulty sleeping because of shoulder pain. This leads to a progressive loss of motion (“freezing”) and limited function of the shoulder over several months, a time when there is often less pain but greater difficulty performing daily tasks. Eventually, the condition starts to “thaw” and shoulder motion and function gradually return. Recently, a panel of experts developed a set of treatment guidelines for improving the quality of care for people with frozen shoulder. These guidelines are published in the May 2013 issue of JOSPT.
The expert panel recommends that patients learn about the symptoms that suggest they have frozen shoulder, what to expect as the condition progresses, and the timeline for recovery. They also urge that patients continue to use the affected shoulder during daily activities. In addition, participation in a good treatment program that combines education, mobility and stretching exercises, and joint mobilizations performed by your physical therapist can help manage symptoms and lead to faster recovery of your shoulder motion and function. Heat and other treatments applied to the shoulder can also make mobility and stretching exercises more effective. Finally, your physician may suggest a corticosteroid injection for your shoulder. The combination of an injection with joint mobilizations followed by mobility and stretching exercises has been found to be helpful.
If you have frozen shoulder, making sure you continue to move your shoulder the proper amount is key to your recovery. There are a number of treatment options performed by physical therapists—joint mobilization or manipulation, exercise, and heat, among them—to help speed up your healing. Your physical therapist can help you better understand the condition and, after a thorough evaluation, customize a treatment program that will include exercises for you to perform at home to decrease the pain and improve the motion and function of your shoulder. For more information on the treatment of frozen shoulder, contact your physical therapist specializing in musculoskeletal disorders.
FROZEN SHOULDER TREATMENTS
Several treatment options are available to address frozen shoulder. A thorough evaluation will help define the right treatment approach for your shoulder. In addition to education on the condition, your physical therapist will help determine the right combination of stretching and mobility exercises and joint mobiliza-tions to get you on the road to recovery.