Acupuncture for Shoulder Pain

You Need This Treatment: Acupuncture for Shoulder Pain

            Acupuncture can be beneficial for shoulder pain from the smallest discomfort to more severe conditions, such as frozen shoulder or arthritis. According to the National Institutes of Health, the reported annual occurrence of shoulder pain is 14.7 per 1000 patients per year with a lifetime frequency of up to 70%. The most alarming part is not only that these numbers are from 2011 and likely have grown, but that the recurrence rates are high, with 25% of those who have shoulder pain reporting previous issues and 40-50% reporting chronic pain or recurrence. It is important to understand both western and eastern methods of healing the shoulder so that we can better assist our patients.

Shoulder Pain in Western Medicine

            Shoulder pain can derive from a multitude of causes. Whether it is from overuse (from occupations such as line workers, mechanics, manual therapists, etc.), sports injuries, a lifting injury, or an accident, shoulder pain is a real problem in the United States, and it’s easy to see why. The shoulder joint is unique and complex because it is one of the few ball and socket joints in the body, providing massive flexibility, but also leaving it vulnerable to injury.

Shoulder joints:

  • Glenohumeral joint – formed by the humerus and scapula connecting at the glenoid cavity (socket).

  • Acromioclavicular “AC” joint – formed by the acromion (tip of the scapula) and the clavicle.

Along with these joints there are many tendons, ligaments, and muscles, known as the rotator cuff, which stabilize and support the shoulder. However, if one of these becomes injured it can unsettle the entire musculature of the shoulder.

Common causes of shoulder pain:

  • Injury – fractures, sprains, strains, dislocated shoulder, frozen shoulder, overuse, and bone spurs.

  • Shoulder bursitis – the bursa (fluid-filled sacs) that cushion movement becomes inflamed from infection or irritation.

  • Tendonitis – tendons in the shoulder become inflamed and tear.

  • Arthritis – just like it affects other joints in the body causing pain, limited range of motion, and inflammation, it can do the same with the shoulder joints.

Generally, a physician will determine the severity of the shoulder pain and if there are any structural problems to rule out, such as spine or neck issues. If needed, it will be recommended that the patient gets an x-ray, MRI, CT scan, EMG, or arthroscopy to take a closer look at the issues.

Common Western Medicine Treatments for Shoulder Pain:

  • NSAIDs like Ibuprofen or Tylenol to manage the pain.

  • Alternating heat and ice to reduce swelling.

  • For separations, fractures, or dislocations, the physician will have to put the shoulder back into the proper position, and the patient will wear a sling to keep it in place for healing.

  • Corticosteroid injection into the joint for pain relief and swelling.

  • Exercises at home to help strengthen and stretch the joint and improve range of motion.

  • Frozen shoulder, cartilage tears, or rotator cuff tears will need surgery if they do not improve with rest and over the counter medication.

For more serious injuries, it is obviously good to have an integrative approach to a patient’s care, but acupuncture is a great modality for issues relating to shoulder pain.

Acupuncture for Shoulder Pain

            When treating shoulder pain with acupuncture, it’s important to relieve the pain, decrease inflammation, increase range of motion, and release tight muscles. Additionally, acupuncture can help with shoulder pain by increasing blood flow and circulation. When the blood is moving properly, it allows the body to heal faster and promote healing. Regarding shoulder pain specifically, acupuncture works by balancing the electrical gradient in the nerves, cells, and fascia as well as increasing the production of synovial fluid in the shoulder to strengthen smoother movement.

When working with patients who have suffered a shoulder injury, it is important to remind the patient that just like any other treatment, it will take time, and it is important to go through all stages of healing to gain the long-term results that acupuncture is famous for.

Acupuncture Treatment Stages for Shoulder Pain:

  • Symptom Relief – the goal in this stage is helping the patient find relief from symptoms of shoulder pain. This may mean more frequent sessions at first to change the painful muscle memory pattern, and generate a new one.

  • Curative Care – the goal in this stage, once symptoms are better managed, is to address the underlying condition or dysfunction all while the body is learning to heal itself through acupuncture treatment.

  • Upkeep Care – once the patient’s symptoms are improved, the goal in this stage is to maintain results, and more than likely can reduce the frequency of sessions.

While many patients that come in with shoulder pain usually obtain it from an injury or arthritis, acupuncture can help with a wide variety of shoulder pain issues.

Acupuncture Can Help With Shoulder Pain:

  • Tendonitis – Acupuncture helps to reduces inflammation and alleviates movement restrictions.

  • Bursitis – Acupuncture addresses this both directly and indirectly; the local points help inflammation through histamine released in the tissue.

  • Arthritis – Acupuncture addresses the inflammation, tension, and muscle guarding that occur in and around the joints.

  • Frozen shoulder – Acupuncture helps to increase blood flow and circulation to the joint.

  • Rotator cuff injury – Acupuncture promotes blood flow, and helps heal the damaged tissue.

  • Labrum injury – Acupuncture helps restore muscle tone and function.

  • Recovering from surgery – Acupuncture stimulates blood flow helping the body to heal the damaged tissue.

There are a number of options for acupuncture and trigger points depending on the specific location and severity of the shoulder pain. Many times, the patient’s shoulder pain is resulting from tight muscles which are resolved by freeing the tight band of muscle causing the pain.

Trigger Points for Shoulder Pain:

  • Posterior Pain:

    • Iliocostalis, deltoid, trapezius, levator scapulae, triceps, scalene, latissimus dorsi, supraspinatus, serratus posterior superior, teres major/minor, subscapularis

  • Anterior Pain:

    • Latissimus dorsi, infraspinatus, coracobrachialis, deltoid, biceps brachii, scalene, pectoralis major/minor, supraspinatus

Acupuncture Points for Shoulder Pain:

  • C4 Huatuo – Sides of the Spine at C4 – Huatuojiaji – located .5 cun lateral to the lower border of the spinous processes of C4. Helps with shoulder tension.

  • HT1 – Highest Spring – Ji Quan – located in the center of the axilla on the radial side of the axillary artery. Regulate Qi flow from the torso to the arm and vice versa, cold numbness pain in the shoulder and/or arm.

  • LI4 – Upper Arm – Bi Nao – located on the radial side of the upper arm 7 cun above LI11. Local point for pain in the upper arm and shoulder, and weakness in the upper arm.

  • LU2 – Cloud Gate – Yun Men – located 6 cun lateral to the anterior midline above the acromioscapula in the depression below the acromial end of the clavicle. Local shoulder point.

  • PC2 – Celestial Spring – Tian Quan – located 2 cun below the anterior axillary fossa, between the two heads of the biceps brachii muscle. For localized pain the shoulder and chest, and calms the spirit.

  • SI13 – Crooked Wall – Qu Yuan – located at the medial extremity of the suprascapular fossa midway between SI10 and the spinous process of T2. Local point for shoulder/scapular pain and chronic shoulder issues.

  • ST38 – Ribbon Opening – Tiaokou – located on the anterior aspect of the lower leg 8 cun below ST35 one finger width lateral from the anterior border of the tibia. Empirical point for shoulder issues including pain, motor control, and adhesive capsulitis or frozen shoulder.

  • UB41 – Attached Branch – Fu Fen – located on the back 3 cun lateral to the lower border of the spinous process of T2.

Acupuncture Treatment and Shoulder Pain

Acupuncture can be a helpful treatment options for patients dealing with shoulder pain, and the beauty of this is that there are a multitude of approaches that we as providers can take depending on our patient’s individual issue. It is vital that we share as much information as possible with our patients regarding their options for shoulder pain treatment with acupuncture and Traditional Chinese Medicine, and that it is both healing in its own right or as an inclusive modality with western medicine in their healing journey.

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