What causes shoulder pain?

Some common causes of shoulder pain is rotator cuff dysfunction due to tendonitis, bursitis, adhesive capsulitis, arthritis, bone spurs, dislocation or broken shoulder bone, and nerve injury (Uppal et. al., 2015).

A sudden shoulder pain with sharp and crushing pain that runs from your chest to the left jaw, arm or neck, accompanied with shortness of breath, dizziness, or sweating may be a sign of a heart attack (Arthritis Australia). Call emergency number “000” if you experience the above.

Injury to the shoulder like dislocation is very painful and need immediate attention. Call the ambulance to receive treatment.

Frozen shoulder

FS is also known as adhesive capsulitis (Kim, 2021).

What is the cause of FS?

According to research, inflammation in the shoulder joint & surrounding capsule can occur due to overuse. According to Uppal et. al (2015), frozen shoulder happens when there is a contracture in the capsule of the shoulder joint, thus reducing the capsular volume and restricting movements. Sometime previous injury to the muscles, tendons and ligaments may also cause your shoulder to become stiff.

Existing medical condition like arthritis, diabetes, and thyroid disorder can contribute to the above conditions.

Signs and symptoms

You may experience:

It has been shown that a high percentage of women age between 40 and 60 years are prone to frozen shoulder (Uppal et. al, 2015).

What can you do?

Depending on the intensity of discomfort, you can:

• check with your GP and get referral for imaging service
• take pain-killer for temporary relief if pain is unbearable with advise from the GP
• corticosteroids injection
• book a treatment with your physio, massage, acupuncture or chiro
• do range-of-motion exercises with advise from your therapist
• seek opinions for surgery if the cause is not due to surgery

How does acupuncture help?

Conventional therapy may recommend a keyhole surgery called arthroscopic capsular release, to cut the tight capsular tissues surrounding the shoulder joint, thus allowing the shoulder to move more freely.

Acupuncture on the other hand, use needles to bring more qi and blood to the area. Green et. al (2005), stipulated that “acupuncture works either by releasing chemical compounds in the body that relieve pain, by overriding pain signals in the nerves or by allowing energy (Qi) or blood to flow freely through the body”.

According to Chinese Medicine, frozen shoulder is known as Bi (painful obstruction) Syndrome.

It is identified by patterns of:

• Wind or Wandering Bi;
• Damp or Fixed Bi;
• Cold or Aching Bi;
• Heat or Febrile Bi. This is a combination of the above which has transformed the stagnation of qi into internal heat;
• Phlegm or Bony Bi. This is chronic stage where deformity may occur.

What can be expected at the acupuncture treatment?

Acupuncture is the primary treatment option, however, electro-acupuncture and cupping to the surrounding structures can be applied to stimulate blood and qi flow.

How many treatment will be required?

Kim (2021) concluded in his case study that 24 treatments were required to show recovery, while others recommended 2 treatments twice per week for 4 weeks to kickstart treatment.

References

1. Arthritis Australia (Shoulder pain), Pain Specialists Australia (Arm pain & shoulder pain), NPS Medicinewise (Non-traumatic shoulder pain in general practice: a pragmatic approach to diagnosis)
2. Green S, Buchbinder R, Hetrick SE. (2005). Acupuncture for shoulder pain: Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD005319. DOI: 10.1002/14651858.CD005319. Accessed 14 November 2022.
3. Kim Y. J. (2021). Acupuncture management for the acute frozen shoulder: A case report. Clinical case reports, 9(11), e05055. https://doi.org/10.1002/ccr3.5055
4. Uppal, H. S., Evans, J. P., & Smith, C. (2015). Frozen shoulder: A systematic review of therapeutic options. World Journal of Orthopedics, 6(2), 263–268. https://doi.org/10.5312/wjo.v6.i2.263