Because shoulder pain often leads to different degrees of dysfunction of the upper limbs, which aggravates the pain of the upper limbs barely moving. In the ancient books of Chinese medicine, those who mainly have shoulder pain but have little influence on normal functional activities are called "shoulder pain" (acupuncture A-B meridian), "shoulder back pain" (Neijing, acupuncture A-B meridian), "shoulder arm pain" (acupuncture A-B meridian) and "Foreshoulder pain" (Neijing). Shoulder pain belongs to arthralgia syndrome since Neijing, which is called "shoulder back arthralgia" and "shoulder back arthralgia" in acupuncture classics A and B, and "shoulder arthralgia" and "shoulder arthralgia" in acupuncture classics Zisheng.
Common syndrome
Wind-cold shoulder pain: shoulder pain is mild, with a short course of disease and a mild degree of pain. The nature of pain is dull pain or dull pain, which does not affect the functional activities of upper limbs. The range of pain is limited to the shoulder, or affects the back of the pulling blade behind the shoulder, or affects the upper arm before the shoulder, which often makes the back of the neck or the upper arm feel anxious. The shoulder feels cold. If you feel warm or touch it, the pain will be relieved. The tongue coating is white and the pulse is floating or normal.
Phlegm-dampness shoulder pain: the muscle pain around the shoulder is severe and the course of disease is long. Although the shoulder joint function activity is normal, it is afraid to move because of the intense pain, and the pain is even worse during the activity, which can cause shoulder joint activity disorder for a long time. My shoulders feel cold and cold, and I feel cold. Although the pain can be temporarily relieved when it is warm, the feeling of pain and cold will still exist at the end. Because of the intense pain, it often affects patients' sleep, diet and normal work. Sweating often due to severe pain. Because of the long course of disease, patients often have symptoms of qi deficiency such as spontaneous sweating, shortness of breath, fatigue and easy to catch a cold. The tongue is pale, the coating is white, and the pulse is thin.
Blood stasis and shoulder pain: if it is caused by flicker, there is an obvious history of external injury. If there is no flash injury, the shoulder pain is severe and the pain is stinging. Although it has been treated by methods such as warming meridians to dispel cold, expelling wind, removing dampness and relieving pain, it has little effect, and it is also blood stasis shoulder pain. The shoulder pain caused by flash-torsion and blood stasis may have slight swelling or no swelling, and the local tenderness of flash-torsion injury is obvious. Long-term illness, blood stasis, shoulder pain, no swelling, wide range of pain, no obvious pain points. Both of them can cause slight disturbance of shoulder joint activity due to pain.
Wind-cold shoulder pain and phlegm-dampness shoulder pain: Wind-cold shoulder pain belongs to mild shoulder pain, which can be called "shoulder pain", while phlegm-dampness shoulder pain belongs to severe shoulder pain, and the pain range is wider than wind-cold shoulder pain. It can be called "shoulder pain and peripheral joint pain". Both are caused by cold and dampness. The former mainly feels cold, while the latter mainly feels cold and wet. The pathogenesis of these two diseases is different. Wind-cold shoulder pain is caused by sweating, or it is accidentally attacked by wind-cold when lying at night, and the evil is in the skin and still on the surface. People who are physically weak have weak skin, often sweat, and are easy to feel cold evil and shoulder pain. "Su Wen. "The Formation of Five Zang Organs" says: "When lying down, the wind blows it, and blood clots on the skin are arthralgia". "synopsis of the golden chamber: the syndrome of treating blood stasis and fatigue" says, "Fu Rong, weak bones, strong skin, sweating from overwork, shaking from time to time when lying down, taking advantage of the breeze." The evil of cold rewelding attacks the skin, and the meridians and qi and blood are blocked, resulting in arthralgia. Its pain is mild and numb. If the body is weak and the yang is not strong, angelica, turmeric and mulberry branches can be used as decoction. If the pain is obvious due to deficiency of qi and blood, Juanbi decoction can be used.
Although phlegm-dampness shoulder pain can also cause cold-dampness pathogen, it is mainly caused by cold-dampness pathogen, which stays between bones and muscles for a long time, with obvious pain symptoms and long course of disease. It is often obtained by lying in a cold and humid place for a long time or soaking in cold water after sweating. "Ling Zhou Shu Bi Pian" says: "Cold and dampness make guests share meat outside, and they are anxious to spit. When the foam is cold, it will gather. When it gathers, it will split and hurt. " Xu Ling's "Birthmark" says: "There is no phlegm in the internal classic, and the foam is phlegm." Foam means wet water, called phlegm. When you are in a hurry, you will get foam, that is, when you are in a hurry, you will get phlegm, and the phlegm will gather between the meat parts and "split the meat parts", so the pain is intense, which is called phlegm-dampness shoulder pain. Neijing called it "Zhou Bi", and acupuncture breeding tablets called it "Shoulder pain Zhou Bi". Staying phlegm and dampness in meat for a long time is not only severe in pain, but also insufficient in qi and blood. Therefore, the treatment is mainly to dispel cold and dampness and tonify qi and blood. Aconitum decoction is used to treat Atractylodis Rhizoma, Atractylodis Rhizoma, Poria and Ji Fang.
Shoulder pain due to blood stasis and phlegm dampness: Shoulder pain due to blood stasis has an obvious history of trauma, with sudden onset, local swelling and tenderness, and the pain is mostly stinging, which affects the functional activities of upper limbs. The treatment is mainly to promote blood circulation, remove blood stasis and relieve pain. Turmeric, frankincense, myrrh and Eupolyphaga Seu Steleophaga can be added to Taohong Siwu Decoction. Phlegm-dampness shoulder pain is severe, the course of disease is long, and there is no obvious history of external injury, and there is no obvious contusion and swelling locally. After a long period of treatment, there is also blood stasis, which is characterized by tingling, stiff tendons, muscle atrophy and no obvious change in fur veins. In addition to dispelling cold and dampness and nourishing qi and blood, the treatment also needs to be supplemented with drugs for removing blood stasis, such as frankincense, myrrh and Toosendan seeds.
Shoulder pain always belongs to arthralgia syndrome, which is caused by wind-cold, phlegm-dampness or blood stasis. The clinical manifestations are mostly cold syndrome, which is mostly empirical at first, while chronic diseases are mostly positive deficiency and evil excess, often accompanied by deficiency of qi, blood, liver and kidney.