Small needle-knife therapy Clinical experience with Massage for Treating

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Common clinical frozen shoulder, also called frozen shoulder, shoulder coagulation disorder, shoulders do not move, the common name leak shoulder style. Most of the patients at the age of about fifty, it is "frozen shoulder," said the author in recent years the use of small needles knife therapy combined with massage for treatment of 50 cases of frozen shoulder, and achieved satisfactory results, are as follows. 1 Clinical data of patients in this group were 50 cases of frozen shoulder, 28 males and 22 females, aged 30 to 70 years, the longest duration of 3 years and the shortest 1 month. Cause
The disease mostly occurs in the elderly, is generally believed that the main pathology of the disease is a chronic degenerative changes, and is therefore shoulder some of the synovial sheath and the local aseptic inflammation by cold, old and loss on repeatedly.
Motherland medicine is due to lack of physical virtual Yue blood, muscle fatigue due to loss of Ru Yang or sweating when the wind leakage shoulder to feel the wind when the wind cold dampness evil and so stepped in, blocking the tendons caused by blood runs sluggish, and acute shoulder pain caused by spasm, movement disorder. after the disease period, even the body can occur limb and shoulder muscle atrophy and other pathological changes in severe adhesions.
3 diagnostic criteria
(1 age 50 years old, no history of trauma, shoulder pain, limited mobility, can not be on the move, particularly night pain,
(2 impairment of shoulder mobility, shoulder gradually restricted activities, including active and passive: in particular outreach arm, and the excessive internal rotation on the back of the hand held touch the waist more obvious when the stiffness. Seriously affect the normal work and life, such as dressing hair washing and other activities.
(3 shoulder function: the contact ear testing (finger touch on the move can not be severe with the ear, over ear can not touch the head is moderate, over the top does not touch on the ear as mild, chest stand on another test (hand through his chest take the opposite shoulder, elbow, chest wall stickers, 10cm away from the midline more than before the severe, 5 ~ 10cm moderate, 5cm or less for mild), back and touch the shoulder test (touch the opposite hand from the back of the shoulder, only can touch and hip sacrococcygeal severe, moderate touch the waist position, the belt more than mild,
(4 tender point: common point of shoulder tenderness around the coracoid process, and before and after the mid-point margin of deltoid, infraspinatus muscle, the size of circular muscles, and sometimes the neck and forearm tenderness may also occur.
(5X-ray showed: no abnormal
4 Treatment
(1 small knife treatment: the coracoid process at the beak and the biceps brachii short head muscle attachment points, just arrived in the supraspinatus muscle side, subacromial infraspinatus and teres minor muscles arrived only end point, conventional disinfection sterile hole shop towels, after local anesthesia with lidocaine knife pressed up to a certain depth of soft tissue, soft tissue incision line should be parallel to the muscle fibers, so that the tool body to do with the muscle fibers perpendicular to the direction of the swing.
began to swing when the arc should small, the intensity of press is also small, then gradually increased, oscillating cutter body, the blade does not leave skin. usually a point swing of 20 to 50 times. the patient can tolerate the limits for the strip method or the longitudinal incision to clear the peel method in the subacromial bursa as transparent peel method. If there are other significant pain around the shoulder point, the pain point in the appropriate needle knife technique. According to lesion size range, each time the treatments 3 to 8 points 1 treatment every 7 days.
(2 manual therapy: the basis of the needle knife, loosen the shoulder joint use of practices, so that adhesions around the shoulder joint are more radical release. Concrete action is: patient was sitting, the surgeon establish the affected side, with right hand thumb, food, three fingers on the grip in the deltoid muscle bundles, as the line perpendicular to the direction of muscle fiber plucked way to go 5 to 6 times, and then plucked the pain near the supraspinatus muscle, chest, etc. The 5 to 6 times. power by the light to the weight, the degree of patient can tolerate.
Then, in the shoulder before the shoulder by shoulder-length for the lateral, kneading, point by such means 10 to 20 times each, and then shoulder surgery patients who held onto the left hand, right hand patients suffering from hand to help them make traction flexion, over their heads, outreach and external rotation, adduction touch the shoulder, extension activities such as internal rotation of 5 to 6 times.
Finally, the doctor holding the injured arm with both hands shake more than 10 times for pulling and rubbing method with repeated twisting from the shoulder to the forearm, 5 to 6 times. 1 a day, 7 days for treatment, massage therapy to this end.
5 function exercise: proper exercise of great help to restore the shoulder, according to the specific situation to choose the following methods:
(1 exercise the limb along the walls climbing walls climbing up the slow moving, so try to hold high the upper extremity.
(2 Kin-hand the human body limb by the handle slowly pull up, repeatedly.
(3 external rotation exercises standing back against a wall, his hands holding elbow flexion, abduction and external rotation movements do, try to make boxing back run into a wall repeatedly.
(4 rotating arm holding a fist around the waist, so turn around the ring shaking, small to large amplitude, action and slow to fast.
6 Clinical criteria:
cure: shoulder pain disappeared, no tenderness, normal range,
markedly: shoulder pain disappeared, only a mild soreness in the activities or uncomfortable, a slight tenderness, range of near normal
improvement: reduce shoulder pain, weight by still tenderness, range of a certain improvement, does not affect the work,
invalid: After treatment, no improvement of symptoms and signs.
7 Results
The group of 50 patients, 35 patients were cured (70.0%, effective in 10 cases (20%), improved in 5 cases (10%) 100.0% total efficiency.
Number of treatment: at least 2 times, up to 6 times the average number of treatment 4.
8 Discussion
Shoulder the greatest degree of human activities is a joint, the most vulnerable to the impact of various factors which led to acute or chronic injury, it is easy to produce a wide range of chronic inflammation, so the affected area, severe pain, the pain and fear of activity, inflammation, metabolism of slowly absorbed , if more subjected to the invasion of wind cold dampness evil, then the meridians are often blocked, not General pain. pain and not moving, can easily cause tissue adhesion, muscle tension contracture, causing pain and dysfunction.
Small needle-knife therapy is a cross between Western medicine and Chinese medicine needle knife combination of organic, non-surgical treatment of closed between the lysis. Incision surgical approach is based on the combination of the formation of acupuncture methods.
Small the advantages of needle-knife therapy treatment is simple, free from any environment and conditions. treatment, small incision, no sutures, and tissue damage is also small, and difficult to cause infection, no adverse reactions, the patient had no obvious pain and fear, no need to rest after surgery, the treatment time is short, short course, were easy to accept.
small knife treatment of frozen shoulder has a good analgesic effect. knife treatment by releasing adhesions and closed some muscles, ligaments release the high stress points, thereby blocking the pain and the vicious circle between muscle tension, local vasoconstriction, reducing inflammatory exudation, release adhesions and reduce connective tissue proliferation, reduce scar adhesions, combined with manual therapy to achieve the anti-inflammatory analgesic , through the meridians, smooth the joints, improve local blood circulation, release muscle damage and tissue adhesion and improve the local supply of nutrients to improve the local metabolism; promote the absorption of inflammation, accelerated the improvement and repair the lesion site. truly "do not make General pain "principle, fundamental to the effectiveness of healing, small needle-knife therapy combined with massage for treatment of frozen shoulder, a quick, short course, less pain, fewer adverse reactions, efficacy consolidation, etc., is worthy of promoting.

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