Acupuncture for Shoulder problems

The Supraspinatous Muscle

A common cause of shoulder pain is ‘supraspinatous tendonitis’. The supraspinatous muscle is one of the rotator cuff muscles and it is illustrated in the diagram.

It lies above the spine of the shoulder blade and attaches to the top of the arm. The reason that it often causes shoulder pain is because the tendon that attaches to the top of the arm often gets trapped and/ or irritated. If you compare the this illustration with the second illustration below, you will see that that muscle has to pass between various bony protuberances in order to attach to the arm.

When there is a problem with this muscle and its tendinous attachment, there is often pain in the deltoid region of the arm, and sometimes this pain extends further down the arm. The pain may be dull, difficult to locate, and it may ‘come and go’. It can be painful at night and there may also be sharp pain when the arm is lifted to the side. Putting an arm into the sleeve of a coat or reaching to the back seat of a car can be painful everyday activities.

There are various tests that can be done to see if there is a problem with this muscle, and careful palpation will confirm results. In fact, careful palpation is the key to acupuncture treatment.

The role of acupuncture

Looking at the first diagram, there is a point ‘SI 12’ marked. This refers to a traditional Chinese acupuncture point on the Small Intestine meridian. This point is used to treat shoulder problems. More recent findings also note this acupuncture point as a ‘trigger point’ of the supraspinatous muscle. For a discussion on trigger points, please follow the link. This trigger point is known to refer pain into the top of the shoulder (deltoid region).

The other acupuncture point, ‘LI 15’ (shown in the diagram), is also used to treat shoulder problems. This point is where the tendon exits the shoulder and attaches to the arm. Acupoint ‘LI 16’ is another area that can be tender when palpated and is worth treating.

Acupuncture is used to help restore proper functioning of the supraspinatous muscle. If the muscle is excessively tight then it is not unusual for it to pull at the point of attachment into the arm and create pain and inflammation. The tendon can become swollen and then impinges between the bones.

If the shoulder does not improve with acupuncture, then the problem may be more serious. For example, the tendon may have a significant tear that is unable to heal, or maybe there is a bony spur that is constantly irritating the tendon. Of course, if an orthopedic practitioner has already carried out other examinations (MRI, etc.) and the findings have come back negative, then acupuncture is a good option to try.

Acupuncture for frozen shoulder

The shoulder is a complicated joint since many muscles are involved in movement and different structures become active at different ranges of movement. For example, when the arm is raised, the first 90 degrees is performed by the shoulder and the next 60 degrees is rotation of the scapula (shoulder bone). Problems will occur with contractile structures, i.e., muscles & tendons, or non-contractile structures such as ligaments, the capsule and bursa. By palpating the shoulder & surrounding areas and testing range of movement in different directions it is possible to evaluate what is causing pain and restricted movement within the shoulder.

Generally acupuncture is very effective in the treatment of shoulder problems. Acupuncture needles are inserted into the most tender areas and other needles further down the arm may be used to move energy along the affected acupuncture channel. The insertion of acupuncture needles is not painful, although some sensation will be felt; sometimes a dull achiness or heaviness in the arm, all signs that the needles are doing their work. Most pain is felt when palpating for painful areas, rather than the acupuncture itself.

The term ‘frozen shoulder’ is a generic terms that covers a multitude of conditions. I take it to mean a shoulder that cannot be slept on. In most cases the condition referred to is ‘capsulitis’ and this can be felt as a ‘clunk’ in the joint as the arm is moved up to maximum elevation. If the capsulitis starts as the result of an accident the result is a traumatic arthritis of the joint affected. Most cases I see in the clinic have been going on for a long time and are a mixture of muscle spasm and capsular involvement.

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