四十肩・五十肩　症例 | 乃木坂YMクリニック

Gender: Female, age 40s

A year ago, I was unable to lift my shoulder. I went to an orthopedic clinic and was given oral medication and stretching instructions, but after about five months, there was no improvement, so I went to another orthopedic clinic and underwent rehabilitation for two months, but there was no improvement. I also received a fascia release injection from another clinic, but there was no improvement, and I was told that the only thing I could do was take Loxonin. I also received acupuncture treatment after that, but there was no improvement. Even now, my shoulder and arm hurt every time I move them, and I feel numbness when I work on the computer, which is painful.

First visit: Pain improved to 39% (VAS). Joint range of motion improved.

7 days later: Pain decreased. Sleeping pain improved significantly. Feels firmer than immediately after treatment.

One month later: Almost no pain in daily life, no numbness. Still some limitation in joint range of motion.

Present: Pain in daily life is almost gone. Since she is now in the recovery phase, she is being followed up every month with stretching instructions to prevent the pain from worsening.

A year ago, I was unable to lift my shoulder. I went to an orthopedic clinic and was given oral medication and stretching instructions, but after about five months, there was no improvement, so I went to another orthopedic clinic and underwent rehabilitation for two months, but there was no improvement. I also received a fascia release injection from another clinic, but there was no improvement, and I was told that the only thing I could do was take Loxonin. I also received acupuncture treatment after that, but there was no improvement. Even now, my shoulder and arm hurt every time I move them, and I feel numbness when I work on the computer, which is painful.

Discussion: The patient's follow-up appointment was actually scheduled a little earlier, but work commitments prevented him from making the appointment. However, perhaps due to careful adherence to home care, such as stretching and refraining from pitching, there was no significant worsening, and at the second visit, the impingement symptoms were clearly improved. After the second treatment, the patient was able to overthrow a light ball without pain. The reasons for the lack of improvement with previous treatments include the incorrect location of steroid injections and inadequate rehabilitation. Only adjustments were made to the shoulder area, and the stretching techniques used during rehabilitation were immature (textbook-based stretching is often ineffective in refractory cases; it is necessary to confirm that the muscles are properly stretched; stretching may have been performed while applying intense stress to the joint in order to move the target muscle; or rehabilitation may have been performed on the wrong muscle). It is possible that a three-dimensional interpretation of the impingement in this case was not possible (as the causes of impingement vary from case to case).

A year ago, I was unable to lift my shoulder. I went to an orthopedic clinic and was given oral medication and stretching instructions, but after about five months, there was no improvement, so I went to another orthopedic clinic and underwent rehabilitation for two months, but there was no improvement. I also received a fascia release injection from another clinic, but there was no improvement, and I was told that the only thing I could do was take Loxonin. I also received acupuncture treatment after that, but there was no improvement. Even now, my shoulder and arm hurt every time I move them, and I feel numbness when I work on the computer, which is painful.

Gender: Female, age 40s

A year ago, I was unable to lift my shoulder. I went to an orthopedic clinic and was given oral medication and stretching instructions, but after about five months, there was no improvement, so I went to another orthopedic clinic and underwent rehabilitation for two months, but there was no improvement. I also received a fascia release injection from another clinic, but there was no improvement, and I was told that the only thing I could do was take Loxonin. I also received acupuncture treatment after that, but there was no improvement. Even now, my shoulder and arm hurt every time I move them, and I feel numbness when I work on the computer, which is painful.

First visit: Pain improved to 39% (VAS). Joint range of motion improved.

7 days later: Pain decreased. Sleeping pain improved significantly. Feels firmer than immediately after treatment.

One month later: Almost no pain in daily life, no numbness. Still some limitation in joint range of motion.

Present: Pain in daily life is almost gone. Since she is now in the recovery phase, she is being followed up every month with stretching instructions to prevent the pain from worsening.

Case: Female Present Illness: Fell approximately one year ago (around July 2024). Supported herself with her right hand, causing pain in her right shoulder joint. Visited an orthopedic clinic for 2-3 weeks with no improvement. Began acupuncture treatment around late November and gradually improved. Due to interrupted treatment, visited our clinic in July 2025.

Duration of illness: Approximately 1 year Most recent treatment period: 8 months

Shoulder Joint Range of Motion: Day 1 Pre-Treatment: Flexion 133°, Abduction 135°, Posterior Internal Rotation T9 Day 1 Post-Treatment: Flexion 157°, Abduction 158°, Posterior Internal Rotation T9 3rd Session (2 months later) Pre-Treatment: Flexion 160°, Abduction 170°, Posterior Internal Rotation T4 After 3rd session (2 months later): Flexion 161°, Abduction 170°, Posterior Internal Rotation T4 Before 4th session (3 months later): Flexion 170°, Abduction 175°, Posterior Internal Rotation T4 After 4th session (3 months later): Flexion 170°, Abduction 176°, Posterior Internal Rotation T4 Translated with DeepL.com (free version)

Treatment Progress: All injections and stretches are performed manually by the physician (Director). Initial Visit: Steroid injection at appropriate site, fascia release injection, appropriate stretching (total 1 hour) 1 week later (2nd visit): Follow-up observation. Stretching only. Pain during sleep reduced. 2 months later: Pain during sleep nearly absent. Range of motion (ROM) showing improvement. Fascia release injection combined with stretching. 3 months later: Sleep pain nearly gone. Range of motion (ROM) showing improvement. Combination of fascia release injections and stretching. Nearly no issues with daily life. Currently receiving regular balance adjustments for each joint, shoulder stiffness, and lower back pain prevention.

A year ago, I was unable to lift my shoulder. I went to an orthopedic clinic and was given oral medication and stretching instructions, but after about five months, there was no improvement, so I went to another orthopedic clinic and underwent rehabilitation for two months, but there was no improvement. I also received a fascia release injection from another clinic, but there was no improvement, and I was told that the only thing I could do was take Loxonin. I also received acupuncture treatment after that, but there was no improvement. Even now, my shoulder and arm hurt every time I move them, and I feel numbness when I work on the computer, which is painful.

Nogizaka YM Clinic

Gender: Female, age 40s

Gender: Female, age 40s

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