Acupuncture for Frozen Shoulder

How Chinese medicine understands frozen shoulder

In Chinese medicine, frozen shoulder has an old nickname: “fifty-year shoulder”, because it tends to appear in middle age. It is usually treated as a type of Bi syndrome, which means pain from an obstruction of Qi and Blood in the channels. The shoulder does not move because, in this view, something is blocking the flow through it.

What causes the blockage decides the treatment. The common patterns are:

• Wind, Cold and Damp. The shoulder aches more in cold, damp weather, feels better with heat, and may feel heavy. Treatment warms the area and clears the channels.
• Qi and Blood stagnation. The pain is sharp and fixed in one spot, and often follows an injury or a long period of holding the arm still. Treatment moves circulation through the area.
• Qi and Blood deficiency. The pain is duller, the shoulder is weak as well as stiff, and you may feel tired in general. In Chinese medicine this is seen as the muscles and tendons not being nourished well enough, so treatment also builds you up.

Most people have more than one of these. That is why two people with the same diagnosis from their doctor can get quite different treatment here.

What treatment involves

Treatment at the clinic in Keswick starts with a full intake: how the shoulder started, which movements hurt, how you sleep, and your general health. An assessment usually includes checking how far both shoulders move, which gives a baseline to measure against.

Acupuncture is usually the main treatment. Points are commonly chosen around the shoulder and also further down the arm and elsewhere on the body. I treat the whole body at every treatment, not only the area that hurts. The aim is to ease pain, relax the muscles guarding the joint, and let you move the arm further with less pain. Needles are very fine, between 0.14 and 0.30 mm.

For a Cold pattern, moxibustion can add warmth to the points. Cupping and tuina massage can help loosen the muscles across the shoulder blade and upper back, which often tighten as you start to favour the arm. When the pattern calls for it, Chinese herbal medicine is a formula written for your pattern.

Frozen shoulder is slow. There is no quick fix, and chronic cases take time. The goal is steady improvement along the way. Plan on 5–10 treatments to judge progress.

Between visits

• Keep moving within comfort. Do the gentle range-of-movement exercises your physiotherapist or doctor gave you, every day. Stop short of sharp pain.
• Warm up first. A warm shower or heat pack for 10 to 15 minutes before stretching often makes the exercises easier.
• Support the arm at night. A pillow under the arm, or hugging one if you sleep on your good side, can reduce night pain.
• Don’t force it. Pushing hard through pain in the early, painful stage tends to flare it up.

When to see your doctor first

See your doctor before starting treatment, or promptly if you are already coming in, if:

• The pain started after a fall or injury, or you cannot lift the arm at all. A fracture or tendon tear needs to be ruled out.
• You have fever, redness, heat or swelling around the joint.
• The pain is on the left side and comes with chest pain, shortness of breath, sweating or nausea. Call 911.
• You have numbness, tingling or weakness running down the arm, which can come from the neck.
• You have unexplained weight loss, or a history of cancer.
• You have diabetes or thyroid symptoms that have not been checked recently.