Acupuncture is one of the only treatments that improve and heal frozen shoulder (FS). Detailed literature reviews find that physical therapy, non-steroidal anti-inflammatory drugs, corticosteroid injections, capsular stretching, exercises, and surgery demonstrate limited evidence of efficacy. In this frozen shoulder case report, acupuncture significantly improved a patient’s symptoms. After eight treatments, pain levels were reduced considerably and stabilized. Furthermore, the patient regained a full range of motion. MRI findings two months post-injury and two months post-acupuncture treatment also provide evidence of anatomical improvement during the course of treatment.
Frozen Shoulder Case Report
The patient in this frozen shoulder case report was a 52-year-old female teacher diagnosed with left-side FS as a result of a traumatic injury. The following is a summary of the details of her presentation:
- Onset: skiing fall impact injury to anterior shoulder one year earlier. Unable to walk with normal arm swing – arm uncomfortable unless in a sling.
- Pain and stiffness with passive and active movement. Normal muscle strength until ROM reaches pain level.
- Gradual onset of pain and stiffness. Unable to do any of her usual aerobic training
- Cold sensation in the shoulder joint
- Unable to ride a bicycle
- Intense pain in the rhomboid muscle area at the level of T1 to T5
- Previous treatment: 1 x cortisone injection and physical therapy
- Palpation elicits tenderness over the anterior glenohumeral joint, upper trapezius, rhomboids, and supraspinatus.
- Range of Motion (ROM) limitations:
- Extension 10 degrees
- Abduction 20 degrees
- Internal rotation 5 degrees
- External rotation 5 degrees
- Flexion 90 degrees
MRI Findings of Frozen Shoulder
Two months post-injury, MRI findings in this frozen shoulder case report showed bone marrow edema in the major tubercle, possibly due to an old tear-off fracture; substantial scar tissue in the subcoracoid bursa; joint capsule and joint capsule and coracoacromial ligament thickening. In addition, the patient’s pulse was deep and fine; her tongue was small, short, pale, and swollen.
Traditional Chinese Medicine (TCM) Diagnosis
Trauma was responsible for the initial Qi and Blood-stasis in the channels of the shoulder, neck, and upper thoracic area. Trauma to the thoracic/cervical spine, ribs, and surrounding muscles as a result of the initial injury was likely to contribute to the patient’s presentation due to their anatomical proximity and neurological associations.
In addition, the cold sensation in the shoulder joint, the intense nature of the pain, and the ‘freezing’ of the ROM all indicated the presence of a cold invasion of the joint. Furthermore, underlying Kidney yang deficiency, as indicated by the tongue and pulse, had most likely prevented the resolution of this condition.
Frozen Shoulder Treatment Plan
Using an integrative approach, applying knowledge of both TCM and neuroanatomy, treatment aimed to reduce pain and increase ROM. Acupuncture treatment was planned for once a week for ten weeks, with the intention to re-evaluate progress at that time.
The TCM treatment principle used was: to circulate Qi and Blood in the channels of the shoulder, neck, and thoracic area; disperse pathogenic Cold in the channels of the shoulder; and tonify Kidney Yang.
Acupuncture Treatment
The practitioner proceeded with deep needling of the points below, which appeared to have a more significant and longer-lasting analgesic effect than superficial needling.
The practitioner utilized the following protocol:
- Needles – They chose 30 gauge, sterile acupuncture needles at a depth and angle of needling according to the standard described.
- Manipulation – They elicited a Deqi sensation (achy sensation) at the start and end of the treatment.
- Accessories – They stimulated select needles with electroacupuncture set at a low frequency of 2.5–5.5 Hz.
- Each treatment session started with the needling of ST38, the master shoulder point.
Frozen Shoulder Protocol
The practitioner in this frozen shoulder case report obtained a deQi sensation at ST38 with deep needling, lifting, and thrusting while the patient moved her arm. After that, they needled LU7 on the right side and KI6 on the left, followed by SP4 on the right side and PC6 on the left. After 20 minutes, they removed the needles in reverse order. Next, the practitioner needled the rhomboid trigger points and applied electroacupuncture for 10 minutes. They followed the same procedure each time the patient came for treatment.
Excellent Results
The patient experienced considerable improvement with acupuncture treatment. A significant increase in ROM and reduced pain were noticeable after each session. In addition, the upper trapezius tenderness decreased after the first treatment. After sessions two and three, the intense thoracic area pain decreased.
Furthermore, the generalized pain decreased over the following weeks. In week seven, pain and stiffness intensified after one week of heavy cross-country skiing but settled significantly after acupuncture. Following her eighth session, the pain level was significantly reduced and stabilized, and she regained full ROM.
Frozen Shoulder Rehabilitation
Rehabilitation then focused on shoulder strengthening exercises and a return to normal activities of daily living (ADL). The practitioner advised the patient to perform two stretching exercises daily on her own. One was to crawl her painful arm up a wall using her fingers. She was to start at hip height and crawl up as far as possible.
The other exercise was folding a dishtowel and using it as an extension between her arms and her back. She was to hold her painful arm above her head, bend the elbow and let the lower part of the arm fall towards her back. The other arm was to get hold of the other end of the dishtowel and move it back and forth.
Improvements Seen On MRI
Comparison of the original MRI-findings to those taken two months post-treatment showed significant improvement in the appearance of the joint capsule and the coracoacromial ligament. An orthopedic specialist examined the images and confirmed that these were clinically significant structural changes associated with the resolution of frozen shoulder.
Conclusion
This frozen shoulder case report conclusively showed how acupuncture resolved pain and restored the normal range of movement. At Raleigh Acupuncture, we use a similar protocol and get equally superior results.
Try acupuncture if you have shoulder pain or frozen shoulder. You’ll be pleasantly surprised with the results.
BOOK NOW to schedule an appointment online.
Watch Video About Our Frozen Shoulder Treatment.
Learn about all the conditions we treat.
Reference
Tapper, Suzanne & Stub, Trine. (2011). Case report: Acupuncture treatment for frozen shoulder resulting from traumatic injury. The American Journal of Chinese Medicine. 6 (2). 36-42.
Focus keyphrase: frozen shoulder case report
Photo by Teona Swift: https://www.pexels.com/photo/mature-woman-in-outerwear-with-toothy-smile-6873934/
What our Clients are Saying
Tennis player with shoulder pain. Getting worse to the point of freezing up. Went to acupuncture. Starting easing immediately. Now back to tennis full force with no shoulder pain. I recommend this practice.
After shoulder surgery following a car accident, my shoulder was always stiff and achy. PT helped, but I suffered every day from shoulder pain. I went to Raleigh Acupuncture and they really helped. I did four treatments and my shoulder pain was completely gone.
I’m a golfer and started having trouble with my left shoulder over a year ago. My doctor wanted to do surgery, but I wanted to try other alternatives first. So I tried acupuncture. The folks at Raleigh Acupuncture were very professional, reasonably priced and did excellent work. They resolved my shoulder pain completely. I use them now for other pains in my post-50 body! Thank you Raleigh Acupuncture.