Frozen Shoulder Acupuncture

Frozen Shoulder Acupuncture - Effective Treatment Of Frozen Shoulder

The term "frozen shoulder" is used to describe a variety of conditions that cause pain and limit the range of motion of the shoulder joint. Acupuncture has been used for thousands of years by the Chinese. It is a technique that involves manipulating and inserting fine needles into specific ares of the body with the goal of reducing pain and gain range of movement. Acupuncture works by improving energy movement along the meridian pathways. It is especially useful in treating conditions such as shoulder tendinitis and frozen shoulder symptoms.

Acupuncture For Frozen Shoulder

Several studies have reported that acupuncture can successfully treat frozen shoulder, but the majority of these studies have not been of the randomized, controlled trial (RCT) variety. A new study using the RCT format compared the use of acupuncture (along with exercise) to exercise alone in a small group of frozen shoulder patients. The study, published in the Hong Kong Medical Journal, found that patients treated with acupuncture and exercise demonstrated "significantly greater improvement" on shoulder assessment tests than those using just exercise, and suggests that acupuncture could be useful in cases where more conventional therapies have been unsuccessful.

The exercise/acupuncture group followed the same home and group exercise programs as the exercise group, but also received acupuncture twice a week during the trial. A three-inch, 30-gauge needle was inserted perpendicular to zhongping, an extra acupuncture point located on the lower leg along the stomach meridian. Zhongping was chosen based on the belief that stimulating it can "improve the flow of qi across the shoulder."

A contralateral needling technique was used, in which the right-side acupoint was used for left frozen shoulder and vice-versa. The needle was inserted to a depth of 2.5 inches, followed by wide-amplitude needle rotation simultaneously with lifting and thrusting to produce de qi. The needle was retained for 20 minutes, with three one-minute needle manipulations made during the treatment period. While being needled, the patient also performed a series of functional exercises using the affected shoulder.

Subjects in both groups were assessed using a test called the Constant Shoulder Assessment, which combines patient ratings for pain and activities of daily living with range of motion measurements for a maximum score of 100 points. Assessments were taken at three intervals: baseline (just prior to the start of the study); at the completion of treatment; and at 20 weeks.

Despite the relatively deep needling involved in the trial, the researchers reported that no acupuncture-related complications occurred during the course of care. However, one patient in the acupuncture/exercise group discontinued treatment after the second session due to fear of needle pain.

Some limitations were noted by the investigators -- for instance, the number of exercise minutes between groups. The exercise-only group performed supervised shoulder exercises for a total of 360 minutes over the treatment period, whereas the acupuncture/exercise group performed supervised exercises for 600 minutes (360 in a group setting, 240 while being treated with acupuncture). Because acupuncture is known to relieve pain, the researchers speculated that patients who had acupuncture before exercise may have shown greater improvements because they experienced less pain during exercise. Similar concerns were raised about the size discrepancies between groups (the acupuncture/exercise group had 13 patients, while the exercise-only group had 22) and the lack of a control group to disprove the placebo effect.

Despite the limits, the researchers saw promise for the use of acupuncture in conjunction with exercise to treat frozen shoulder. "The combination of acupuncture and physical exercise may be an effective option in the treatment of frozen shoulder," they wrote. "This study provides additional data on the potential role of acupuncture in the treatment of frozen shoulder, particularly for those patients not responding well to conventional therapy." They recommended that larger, placebo-controlled trials be designed to measure short- and long-term outcomes, and that a more uniform method of defining frozen shoulder be established, which would result in valid and more reliable treatments.