Shoulder Pain Research 2

Acupuncture is effective in relieving chronic shoulder pain (CSP). This shoulder pain research from the Meiji University of Integrative Medicine concluded that true acupuncture was more effective than sham acupuncture for the relief of CSP. In another study by Shi et al., acupuncture combined with Mulligan Manual Therapy (MMT) relieved rotator cuff injuries and demonstrated superior patient outcomes to using MMT alone.

Acupuncture Safe for Treating Shoulder Pain

Kazunori et al. concluded that acupuncture was safe and effective for treating CSP. Two groups were compared. One group received true acupuncture, and the other group received sham acupuncture. The true acupuncture treatment group outperformed the sham control group in terms of pain reduction and functional improvement. Investigators measured the results with the visual analog scale (VAS) and Constante-Murley scores (CMS).

Shoulder Pain Study Exclusion Criteria

The shoulder pain research involved 18 patients. Inclusion and exclusion criteria included:
Shoulder pain lasting for six months
Insufficient response to medications prescribed by orthopedic specialist
An average pain score of 50 or more on a 100-point visual analog scale (VAS)
Age between 40 years and 70 years
No osteoarthritis of the glenohumeral joint or systemic bone or joint disorder (e.g., rheumatoid arthritis)
No history of shoulder surgery
No other current therapy involving analgesics
Has not received acupuncture in the last six months

Investigators excluded patients with significant trauma or systemic diseases from the study. Next, they randomly divided patients into two groups, a true acupuncture treatment group and a sham control group, with eight patients in each. There were no statistically significant differences between the two groups in terms of age, disease, pain duration, VAS, or drug use for patients initially admitted to the study.

Acupuncture Treatment for Shoulder Pain

The true acupuncture group received acupuncture treatment at myofascial trigger points, many of which were ashi (tender) points. First, an acupuncturist examined neck and superior limb muscles to identify trigger points. Then, they inserted sterile, single-use, disposable needles into each acupoint to a maximum depth of 5–15 mm. They used the sparrow-pecking technique to elicit a local muscle twitch response.

For the sham acupuncture group, specially developed fake needles did not penetrate the skin. They had a dull, round tip. A simulation of needle extraction was performed by touching the patient and noisily dropping needles into a metal tray. To facilitate blinding, patients in both groups wore eye masks during treatment.

Shoulder Pain Study Outcome Measures

Researchers measured outcomes immediately before the first treatment and at weeks 1, 2, 3, 4, 5, 10, and 20 after the treatment. The VAS score for the true acupuncture group decreased significantly five weeks after treatments began. Comparison between the two groups demonstrates that “compared with sham acupuncture therapy, true acupuncture is more effective for the treatment of chronic shoulder pain.”

Electroacupuncture Relieves Shoulder Pain

Shi et al. from the Shanghai Jiaotong University Affiliated Renji Hospital investigated the effects of electroacupuncture and MMT on rotator cuff injuries. Rotator cuff injury is a common cause of CSP. MMT is a physical therapy technique used to treat musculoskeletal injuries. The researchers determined combining both modalities is a more effective treatment protocol than using only MMT. Investigators measured results with the VAS, the UCLA shoulder rating scale, the Shoulder Pain and Disability Index (SPADI), and the Range of Motion for the Shoulder (ROM).

Electroacupuncture Points for Shoulder Pain

Practitioners used the following points for the electroacupuncture treatment:
LI14 (Binao)
LI15 (Jianyu)
SI9 (Jianzhen)
SJ14 (Jianliao)
SI11 (Tianzong)
Extra points

Upon disinfection, they inserted sterile, single-use needles into each point to a standard depth. After achieving a deqi sensation, they applied the technique of the ping bu ping xie (mild tonifying and attenuating). Then, they applied electroacupuncture to acupoints Jianyu, Jianzhen, Tianzong, and Jianliao using a continuous wave (100 Hz, ＜3 mA) for 30 minutes.

Shoulder Pain Research Conclusions

After treatment, the VAS score in both groups decreased significantly. However, the score of the treatment group was significantly lower than that of the control group. After the treatment, the UCLA score increased dramatically for both groups, while the SPADI score significantly decreased; the UCLA score of the treatment group was significantly higher than that of the control group, and the SPADI of the treatment group was significantly lower than that of the control group.

Both groups’ ROM (degree of abduction and lateral rotation) increased substantially from scores before treatment. Also, the degree of abduction and lateral rotation of the treatment group was significantly higher than that of the control group. Results indicate that acupuncture with MMT is more effective than using only MMT.

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References

Kazunori I， Shingo S， Shunsaku S， Yuki N， et al.， Hiroshi K. (2015). Randomized trial of trigger point acupuncture treatment for chronic shoulder pain: a preliminary study. Journal of acupuncture and meridian studies, 7(2).

Shi YM, Yu L, Mao JJ, et al. (2019). Effect of electroacupuncture combined with joint mobilization on pain and joint function of patients with rotator cuff injury. World Journal of Integrated Traditional and Western Medicine, 14 (11): 1575-1578.

Focus Keyphrase: Shoulder Pain Research
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