Treating Pain with TCM - Part 3: Shoulder Pain

During my time studying at the TCM University, there were three very common pain problems treated in our student clinic.  These were back pain, knee pain, and shoulder pain.  Out of those three, shoulder pain was the one I treated the most, followed by back pain, then knee pain.

In TCM, shoulder pain happens for one of three reasons.  The first is Qi and Blood stagnation.  This is what happens from overuse, underuse, and injury.  The second is Bi Syndrome.  While close to an arthritic condition, it has to do with the combination of Wind, Cold, and Damp at the joint.  Heat also plays a part later as well.  Bi Syndrome can also occur after an injury if it's not treated correctly.  This is why an old injury hurts in a change of weather (Windy, Cold outside, and Rainy).  Lastly, you have the thicken of the joint capsule, which leads to a condition called "Fifty's Shoulder" or frozen shoulder.  This condition starts to occur later in life.

Generally, treatment consists of Acupuncture or Electroacupuncture, Tui Na, TENS, Cupping, Moxibustion, and an external rubbing oil/herbs.  Tui Na or a TENS is used first to loosen the muscles and allow blood to start flowing through the area.  Then acupuncture / electroacupuncture is used to relax the muscles more and allow clearing of the Bi syndrome or stagnation.  Moxabustion will also be used with the needle if there is Cold in the area.  To finish, Tui Na is done again softly adding oil, such as Bai Hua (white flower) oil or Kwan Loong Oil, or an external herbal formula, such as Die Da Jiu.

Most acupuncture points are used on the shoulder itself, such as Large Intestine 15 and 16, Small Intestine 9-14, San Jiao 13-15. You can use acupuncture off the channels, depending where there's pain and soreness. This follows the same Ashii theory as outlined in the Huang Di Nei Jing as I've mentioned in other articles.  If there's pain in the muscles, use the needle in the muscles. If there's pain in the tendon, use the needle in the tendon. If there's pain in the bone, use the needle (next to) at the bone.  While all these points are good, there are two other points that work very well for shoulder pain.  Oddly enough, they're on the legs.

Gallbladder 34 and Stomach 38 both work very well in treating shoulder pain.  GB 34, Yang Ling Quan, has a special property that helps treat tendon and ligament pain anywhere on the body.  Stomach 38,  Tiao Kou, can help loosen the shoulder joint.  Almost all treatments I did for patients with shoulder pain consisted of using one or both of these points. 

GB 34 can be used without stimulation during the initial treatment when the patient is laying down. However, ST 38 has to be manually stimulated for it to work properly.  As you manipulate the needle, you need to direct the patient to slowly rotated his arm.  At certain points, you alter the manipulation and ask the patient to increase the rotation.  After a few minutes of this stimulation, their range of motion should greatly increase.

Thank you again for reading the article.  At some point, I'd like to write about some of the pain cases I've seen in the clinic.  It may help you to get a better idea on how we diagnosis and treat these pain conditions with TCM.

---