Acupuncture for Shoulder Pain – Scott Stephens (Acupuncturist)

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Are you looking for shoulder pain relief in the Mornington Peninsula area? Make an acupuncture appointment for shoulder pain now or read on to discover more about acupuncture for shoulder pain.

The recent research paper the ‘Acupuncture evidence Project 2017’, has stated that current research shows acupuncture has evidence of potential positive effect.

What is shoulder pain?

Shoulder pain can be a result of injury or disease of the shoulder joint. Injury can affect any of the ligaments, bursae, or tendons surrounding the shoulder joint. Injury can also affect the ligaments, cartilage, meniscus, and bones of the joint. Common injuries of the shoulder can lead to bursitis or tendonitis and result in a torn rotator cuff with dysfunction, impingement, as well as instability and frozen shoulder. Labral tears can be from torn cartilage. Fracture of the bones of the shoulder can cause intense shoulder pain.

Pain can also occur in the shoulder from diseases or conditions that involve the shoulder joint (including arthritis such as osteoarthritis or degenerative arthritis with bone spurs), the soft tissues and bones surrounding the shoulder, or the nerves that supply sensation to the shoulder area.

Source – William C. Shiel Jr., MD, FACP, FACR Shoulder Pain: Symptoms & Signs, Medicine Net, Retrieved from https://www.medicinenet.com/shoulder_pain/symptoms.htm

How many people are affected by shoulder pain?

Shoulder conditions are among the most common musculoskeletal presentations seen in general practice and up to 95% of people with shoulder pain are treated in the general practice setting.

Source – Brun S, Shoulder injuries Management in general practice (2012) Volume 41, No.4, April 2012 Pages 217-220. Retrieved from https://www.racgp.org.au/afp/2012/april/shoulder-injuries/

Shoulder pain symptoms

Pain in the shoulders has many different causes. The pain may occur in the joint itself, or in the many muscles, tendons and ligaments in the shoulders. Shoulder pain is usually felt in the front of the shoulder, or at the top of the arm. Often, the pain is only felt when you move your arm in a certain way. If you have shoulder pain, but you are also having trouble breathing and feel a tightness in your chest, you may be having a heart attack. You should seek medical attention immediately by dialling triple zero (000) and asking for an ambulance. You should also seek immediate medical attention if you have injured your shoulder – for example, while playing sport or in a fall. Otherwise, if you have shoulder pain that won’t go away, or which is getting worse, or you have other symptoms that are causing you concern, make an appointment to see your health care professional.

Source – Health Direct. Retrieved from https://www.healthdirect.gov.au/shoulder-pain

WM Diagnosis of shoulder pain

Shoulder Pain Relief MorningtonShoulder injuries may present as acute, chronic or acute-onchronic conditions. If the patient is examined very soon after an acute event, movements and palpation anywhere in the region of injury may elicit tenderness and discomfort, making assessment difficult. Progressive biomechanical changes occur after any shoulder injury to compensate for pain or dysfunction. These events alter the natural symmetry and synergy of shoulder movement, compounding the injury and dysfunction. Early intervention, restoration of normal function and appropriate analgesia are therefore important. Around 23% of all new episodes of shoulder pain completely resolve within 1 month and 44% within 3 months of initial onset. Approximately 50% of people with acute shoulder pain who are treated conservatively recover within 6 months and approximately 60% recover within 12 months. The patient’s personality traits, coping style and occupational factors may determine if the shoulder pain becomes chronic. With the exception of red flag conditions, there is no need of urgent referral for most acute shoulder injuries. The acute phase priority is maintaining near-normal function and biomechanics by providing appropriate analgesia and early health care involvement.

Source- Brun S, Shoulder injuries Management in general practice (2012) Volume 41, No.4, April 2012 Pages 217-220. Retrieved from https://www.racgp.org.au/afp/2012/april/shoulder-injuries/

 

 

WM Treatment of shoulder pain

The treatment recommended for your shoulder pain will depend on the cause. If your shoulder pain is due to minor injury, you may be able to organise some treatments at home yourself with rest being the best thing to do. Pain relievers or anti-inflammatory medications may also help control the pain.

But for persistent or intense pain, or if you’re injured, you should see a doctor or health care professional who may suggest: resting your shoulder for some time (usually only a couple of days), taping your shoulder for support, or resting your arm, acupuncture, massage, exercises, laser or ultrasound therapy. Steroid injections or surgery may be recommended for some injuries.

Source – Health Direct. Retrieved from https://www.healthdirect.gov.au/shoulder-pain

CM view of Shoulder Pain

Chinese medicine views shoulder pain predominantly with the view that there is a stagnation in the flow of Blood and Qi in the affected are, this may also be accompanied by heat in the local area (inflammation). As there are many different reasons for shoulder pain such as trauma or disease such as arthritis, Chinese Medicine will do a unique diagnosis for each individual who is suffering from shoulder pain. For this condition a combination of Chinese Medicine practices may be used such as acupuncture, electro-acupuncture, Tui Na (massage), cupping, Gua Sha, stretching and the applying of herbal liniments or plasters.

Current research on acupuncture for shoulder pain

Acupuncture for pain researchThere are several current research articles that give support to acupuncture giving relief of shoulder pain. Below are some examples and explanations of the research that supports acupuncture for the treatment of this condition.

The recent research paper the Acupuncture evidence Project 2017, has stated that current research shows acupuncture has evidence of potential positive effect. There are currently no other large scale systematic reviews for the treatment of shoulder pain with acupuncture, but this recent research finding is promising for positive outcomes in upcoming research.

Source- McDonald J, Janz S. (2017), The Acupuncture Evidence Project: A Comparative Literature Review (Revised edition). Brisbane: Australian Acupuncture and Chinese Medicine Association Ltd; 2017. Retrieved from http://www.acupuncture.org.au.

Treatments for Shoulder Impingement Syndrome – A PRISMA Systematic Review and Network Meta-Analysis (2015)

Included in the meta-analysis procedure were 33 randomized controlled trials involving 2300 patients. Good agreement was demonstrated between the results of the pair-wise meta-analyses and the network meta-analyses. Regarding nonoperative treatments, with respect to the pain score, combined treatments composed of exercise and other therapies tended to yield better effects than single-intervention therapies. Localized drug injections that were combined with exercise showed better treatment effects than any other treatments, whereas worse effects were observed when such injections were used alone. Regarding the CMS, most combined treatments based on exercise also demonstrated better effects than exercise alone. Regarding surgical treatments, according to the pain score and the CMS, arthroscopic subacromial decompression (ASD) together with treatments derived from it, such as ASD combined with radiofrequency and arthroscopic bursectomy, showed better effects than open subacromial decompression (OSD) and OSD combined with the injection of platelet-leukocyte gel. Exercise therapy also demonstrated good performance.

Exercise and other exercise-based therapies, such as kinesio taping, specific exercises, and acupuncture, are ideal treatments for patients at an early stage of SIS. However, low-level laser therapy and the localized injection of nonsteroidal anti-inflammatory drugs are not recommended. For patients who have a long-term disease course, operative treatments may be considered, with standard ASD surgery preferred over arthroscopic bursectomy and the open surgical technique for subacromial decompression. Notwithstanding, the choice of surgery should be made cautiously because similar outcomes may also be achieved by the implementation of exercise therapy.

Source- Dong W, Goost H, Lin XB, Burger C, Paul C, Wang ZL, et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis (2015), Medicine (Baltimore). 2015 Mar;94(10):e510. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25761173

Acupuncture for Poststroke Shoulder Pain: A Systematic Review and Meta-Analysis (2016)

Shoulder pain is a common problem following a stroke, and 75% of patients complain of pain in the first 12 months after a stroke. This interferes with activity, recovery, and rehabilitation. It requires a coordinated multidisciplinary pain management approach to minimize interference with rehabilitation and optimize outcomes. Acupuncture is an effective treatment for chronic pain in many patients. An NIH consensus report also stated that the incidence of adverse effects of acupuncture is substantially lower than that of many other accepted medical interventions. In the current study, we too did not report any adverse acupuncture-related events in patients with poststroke shoulder pain.

Source –  Lee SH, Lim SM. Acupuncture for Poststroke Shoulder Pain: A Systematic Review and Meta-Analysis (2016), Evid Based Complement Alternat Med. 2016;2016:3549878. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983325/

What’s involved in an acupuncture session?

Acupuncture Shoulder Pain MorningtonInitial Acupuncture sessions are around an hour long with a discussion about the condition specifics including what helps or makes the pain worse as well as other areas of diet and lifestyle to gain an understanding of how each individual patient’s body works. Once the practitioner has sufficient information to formulate a Pattern of Disharmony, which is Chinese Medicines way of diagnosing, the Acupuncture needles will be inserted into the skin. The patient may be face up or down on the massage table which changes with each condition. With low back pain conditions, needles will be put into the area of the pain along with other ‘points’ on the legs arms and sometimes head. Once the needles are in, the patient will be left on the table for rest for around 20 minutes with dimmed lighting and relaxing music. After the time ends, the practitioner will return to the room to remove the needles and discuss how you are feeling after the treatment. Subsequent weekly treatments are shorter at around 30 to 40 minutes as a discussion at the beginning is more of a catch up however needles will always be in for around 20 minutes.

 

Chinese medicine modalities that may be used in a session for shoulder pain

In some cases, additional tools may be employed when dealing with shoulder pain along with massage, stretching, use of liniments and electro Acupuncture. Electro involves attaching small clips linked to a TENS machine by cords to certain needles after they are inserted into the skin. The machine is then turned up until a buzzing feeling can be felt by the patient at the site of the connected needles. This works deeper into the muscle to help relieve pain. Once the needles are all removed at the end of the treatment, different liniments, dependant on the cause of the pain, may be applied to the area also. Many feel much like a ‘Deep Heat’ would with a cool feeling in the area as they dry. This will be discussed with you before application of the liniment at the time of the appointment.

 

Claiming health funds for acupuncture

At Mornington Chinese Medicine we offer a Hicaps terminal meaning rebates can be paid at the time of appointment and only the gap payment is your out of pocket expense. If you have Private Health Insurance with Extras, it is best to check to see if you are covered with Acupuncture to be sure you receive a rebate. Please note that Hicaps is only available for Acupuncture treatments and that any Herbs or supplements will be at full cost.

Before your acupuncture session

Make sure you have eaten something on the day of an Acupuncture treatment and bring along any information you currently have pertaining to the condition. This can include blood tests x-rays or scans performed on the issue along with any Western Medical diagnosis you have been given.

How to book for acupuncture

If you are suffering from shoulder pain please call Mornington Chinese Medicine today to discuss how we can help you.

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References

Brun S, Shoulder injuries Management in general practice (2012) Volume 41, No.4, April 2012 Pages 217-220. Retrieved from https://www.racgp.org.au/afp/2012/april/shoulder-injuries/

Dong W, Goost H, Lin XB, Burger C, Paul C, Wang ZL, et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis (2015), Medicine (Baltimore). 2015 Mar;94(10):e510. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25761173

Health Direct. Retrieved from https://www.healthdirect.gov.au/shoulder-pain

Lee SH, Lim SM. Acupuncture for Poststroke Shoulder Pain: A Systematic Review and Meta-Analysis (2016), Evid Based Complement Alternat Med. 2016;2016:3549878. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983325/

McDonald J, Janz S. (2017), The Acupuncture Evidence Project: A Comparative Literature Review (Revised edition). Brisbane: Australian Acupuncture and Chinese Medicine Association Ltd; 2017. Retrieved from http://www.acupuncture.org.au.

William C. Shiel Jr., MD, FACP, FACR Shoulder Pain: Symptoms & Signs, Medicine Net, Retrieved from https://www.medicinenet.com/shoulder_pain/symptoms.htm