What is the best treatment and most effective medication for shoulder periarthritis?

Generally speaking, there is no single best treatment or miracle drug for shoulder periarthritis (frozen shoulder), but effective treatments and medications are available. The choice of treatment should be based on the specific underlying cause. Causes include repetitive labor, poor posture, shoulder dislocation, degenerative changes in the shoulder joint, and fractures. Medications may include ibuprofen sustained-release capsules, celecoxib capsules, diclofenac sodium sustained-release tablets, Huoxue Zhitong ointment (a traditional Chinese medicine plaster), and flurbiprofen gel patches. If discomfort occurs, it is recommended to seek medical attention promptly. Detailed analysis is as follows:

I. Causes

1. Repetitive Labor
Frequent lifting of heavy objects, repeated upper limb movements, or prolonged repetitive tasks can lead to damage of tissues surrounding the shoulder joint, which may gradually develop into shoulder periarthritis. For individuals engaged in repetitive work, key preventive measures include adopting proper working postures and techniques, taking regular breaks, relaxing muscles, performing appropriate shoulder and upper limb exercises, and using ergonomically designed tools and equipment.

2. Poor Posture
Maintaining poor posture over long periods is another factor contributing to shoulder periarthritis due to repetitive strain. For example, prolonged低头 (bending the head forward) or bending over while working increases pressure and stress on the tissues around the shoulder joint, increasing the risk of developing shoulder periarthritis. Remaining in the same position for extended periods places strain on the body; therefore, regular rest and movement are essential. It is advisable to stand up and walk around periodically, perform stretching exercises, and relax the muscles and joints.

3. Shoulder Dislocation
Trauma or injury to the shoulder, such as shoulder dislocation, may trigger shoulder periarthritis. A qualified physician can perform joint reduction, followed by cold compresses with an ice pack to help alleviate pain.

4. Degenerative Changes in the Shoulder Joint
Degenerative changes in the shoulder joint are often associated with aging. As people age, the cartilage in the shoulder joint may gradually wear down. Cartilage is a smooth tissue covering the joint surfaces, primarily functioning to reduce friction and provide cushioning. When cartilage wears away, increased bone-on-bone friction can lead to inflammation and pain, eventually progressing to shoulder periarthritis. Arthroscopic surgery may be considered as a treatment option. This procedure involves inserting an arthroscope through small incisions, allowing the surgeon to remove inflamed tissue, repair tendon injuries, and restore joint surfaces.

5. Fractures
Fractures are serious injuries that can trigger inflammatory responses in surrounding tissues. This inflammation may spread to muscles, ligaments, bursae, and other soft tissues around the shoulder joint, leading to shoulder periarthritis. Surgical interventions such as internal fixation or external fixation may be performed under medical supervision.

II. Medications

1. Ibuprofen Sustained-Release Capsules
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation, pain, and swelling associated with shoulder periarthritis by inhibiting the synthesis of inflammatory mediators in the body.

2. Celecoxib Capsules
Celecoxib is an NSAID that works by inhibiting cyclooxygenase (COX) activity, thereby reducing prostaglandin production and alleviating pain and inflammation. Celecoxib also has antiplatelet aggregation effects, helping to reduce the risk of thrombosis. This is particularly important for patients with shoulder periarthritis, as inflammation may increase platelet aggregation and elevate the risk of blood clot formation.

3. Diclofenac Sodium Sustained-Release Tablets
Diclofenac sodium sustained-release tablets are NSAIDs that block the transmission of pain signals, reduce pain perception, and relieve shoulder discomfort caused by shoulder periarthritis.

4. Huoxue Zhitong Ointment (Blood-Activating and Pain-Relieving Plaster)
This is a topical herbal ointment containing ingredients such as Chuanxiong (Ligusticum wallichii) and Honghua (Carthamus tinctorius), which promote blood circulation and resolve blood stasis. By improving local blood flow and enhancing circulation around the shoulder joint, this ointment helps reduce numbness and pain associated with shoulder periarthritis.

5. Flurbiprofen Gel Patches
Flurbiprofen gel patches are topical medications. Applied to the affected area, they stimulate local blood circulation and improve blood supply to the injured site. This helps reduce inflammation and muscle spasms, promoting tissue healing and recovery.

In daily life, performing appropriate shoulder exercises can strengthen muscles and improve flexibility, helping prevent shoulder periarthritis. It is recommended to choose suitable shoulder exercises, such as shoulder stretches, rotational movements, and strengthening exercises for shoulder muscles.