Frozen shoulder is common and simple disease clinically, however, the cause of it has not been fully understood. Consequently the treatment of frozen shoulder has not become settled, and the duration of the treatment has taken more than 6 months-many years.
The author reviewed the references on frozen shoulder in order to give a solution of the cause and the treatment.
The cause of frozen shoulder could be summarized as follows, in spite of many reporters have different ideas.
A) Human body takes gradually degenerative process in shoulder rotator cuffs and long head of biceps as in all organs of body after 40 years of age. Over use or trauma of shoulder easily leads to traumatic inflammatory change on the degenerated tendons which gradually spread to the surrounding soft tissues instead of healing as in younger person, and results subacromial bursitis or periarticular adhesion.
B) The dependency of shoulder due to whatever the causes may slow down or stagnate the local circulation which causes local edema, and sero-fibrinous exudation infiltrates into surrounding soft tissues that may result periarticular adhesion.
C) Emotional stress may often happen after 40 years of age, particularly in climacteric women.. It may cause over-secretion of Adrenocortico-steroids and change the water ballance between intra and extra-cellular fluid that may change the property of intrinsic tendons to rigid and inelastic due to disorder of Collagen in them. These changes finally lead to periarticular soft tissue adhesion.
D) Frozen shoulder is the local manifestation of general metabolic faults, that can be explained
by the fact that we have seen much more frozen shoulders in debilitating cases such as
cardio-vascular diseases, pulmonary diseases, or diabetes mellitus. -
The author has experienced the treatment of 108 frozen shoulder cases in the St. Mary Hospital with the new idea acquired from the above mentioned etiology, and shortened the duration of the treatment from 6 months-many years to 6 weeks-12 weeks.
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