Frozen Shoulder (Adhesive Capsulitis)
Overview
Frozen shoulder is characterized by progressively worsening shoulder pain with loss of both active and passive range of motion in all directions, often worse at night, and is common in middle-aged/older adults and after prolonged immobilization or with diabetes. Chinese medicine calls it "leaking-shoulder wind" or "fifty-year shoulder," mainly from age-related qi–blood and liver–kidney deficiency plus wind-cold-damp invasion or strain obstructing the sinew channels. Patterns include wind-cold-damp obstruction, qi stagnation with blood stasis, and qi–blood deficiency. Rotator-cuff injury and impingement should be differentiated.
Pattern differentiation (clinical patterns)
Wind-Cold-Damp Obstruction
Cold heavy shoulder pain worse with cold and relieved by warmth, restricted motion, aversion to wind/cold, thin white coating, wiry tight pulse.
Dispel wind and scatter cold; warm channels and unblock collaterals.
Qi Stagnation with Blood Stasis
Fixed stabbing tender pain with markedly restricted motion, often after injury/strain, dark tongue with stasis spots, rough pulse.
Move qi and invigorate blood; resolve stasis to stop pain.
Qi–Blood Deficiency
Sore weak shoulder worse with exertion and slightly eased by rest, muscle wasting, dull complexion, shortness of breath, fatigue, pale tongue, fine weak pulse.
Boost qi and nourish blood; relax sinews and unblock collaterals.
Connections
Daily care & prevention
Keep the shoulder warm and avoid direct air-conditioning and heavy lifting; within a pain-tolerant range, do gentle stretching and pendulum or wall-climbing range-of-motion exercises, progressing gradually and avoiding forceful manipulation. After heat, massage Jianyu (LI15), Jianjing (GB21), Jianzhen (SI9), Quchi (LI11), and Hegu (LI4). Good glucose control helps in diabetes. Severe pain, inability to move after injury, arm weakness/numbness, or worsening night pain should be evaluated for rotator-cuff tear.
When to seek medical care
Post-traumatic deformity or total loss of motion, arm numbness/weakness, fever/chills with a red hot swollen shoulder, or chest/back pain radiating to the left shoulder with sweating and nausea (rule out cardiac pain) requires prompt care.