TCM Solutions for Frozen Shoulder

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What is the frozen shoulder?

          Frozen shoulder is stiffness and pain in the shoulder joints. It usually occurs after prolonged periods of shoulder immobility due to surgery, stroke, or arm injury (Challoumas, D., et al., 2020). 

How Does it happen?

 

          Frozen shoulder can also be referred to as adhesive capsulitis because the capsule thickens and tenses around the shoulder joints (Kim, Y. J., 2021). It affects more women than men and individuals between the ages of 40 and 60 (Robinson, C., et al., 2012). 

What are the symptoms of frozen shoulders?

          The signs and symptoms of frozen shoulders include stiffness and pain in the shoulder joints. It may also cause difficulty in sleeping on the shoulder that is experiencing pain, and restriction of active and passive elevation and external rotation, without any visible radiological changes (Chandran, K., et al., 2021). The symptoms usually deteriorate slowly and progress over time in three stages: freezing stage (movement of the shoulder causes pain), frozen stage (pain decreases but shoulder stiffens), and thawing stage (mobility begins to improve) (Manske, R. C., & Prohaska, D., 2008). 

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What are the causes of frozen shoulders in Oriental Medicine?

 

          In TCM, it is known as the “shoulder at the age of 50". If the shoulder is not moved, it will lead to stagnation due to a lack of Qi circulation. The deficiency of Qi and blood in the meridians leads to pain, sensitivity, and stiffness in the bones, muscles, joints, and tendons. It can also be caused by the deficiency of Yin and the lack of skin defense against invasion by the pathogenic factors of wind, cold, and dampness in the body (Sun, K., et al., 2001).  

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what can oriental medicine do to treat frozen shoulders?

Acupuncture

          Acupuncture is a TCM modality that involves the insertion of needles into various and specific areas of the body. It is an effective way to treat pain and musculoskeletal disorders, which may restore the function of the shoulder joint and heal frozen shoulders. Studies show that acupuncture will alleviate shoulder pain and disability symptoms and improve the range of motion, flexion, and external rotation (Chandran, K., et al., 2021). 

Ear Acupuncture/Acupressure 

          Ear acupuncture is another TCM modality that uses micro-needling to regulate Yin and Yang viscera through the meridian system to restore the balance of Yin and Yang. Compared with other treatments for shoulder conditions, ear acupuncture is a simple treatment with long-lasting curative effects, is not addictive, and does not have toxic side effects (Hou, X., et al., 2021). Acupressure is much like acupuncture but uses manual pressure applied to specific points to reduce pain. Auricular/Ear acupressure is a safe and effective treatment for curing frozen shoulders symptoms, which improves the range of motion, flexion, abduction, and external rotation (Kim, B. & Park, H., 2020).  

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traditional Chinese Herbs 

          Plants have been used for many centuries to relieve pain and inflammation, such as Yan Hu Suo (Corydalis). It contains DHCB, a pain-relieving compound that blocks pain signals in the brain (Wang, L., et al., 2016). Another herb traditionally used in TCM is turmeric (C. longa) as an anti-inflammatory that can benefit frozen shoulders (Daily, J. W., Yang, M., & Park S., 2016). 

Moxibustion  

          Many studies show that moxibustion is beneficial as a therapy for frozen shoulders (Meng, X., et al., 2022). It improves upper limb motor functions, alleviates pain, increases the ability to perform daily activities, and reduces patients’ depression (Zhao, H., et al., 2020). 

Cupping  

          It is another TCM therapeutic technique that involves the application of suction by creating a vacuum on the skin of the affected part. Cupping has multiple benefits, which include warming the meridians to dispel the cold, promoting Qi and blood circulation, relieving swelling, accelerating healing, and alleviating pain in the neck, shoulders, and lower back (Chi, L.M., et al., 2016). 

Exercise   

          At-home exercises and stretching are excellent ways to treat frozen shoulders. It is recommended to start with gentle stretches and slowly improve the range of motion. Safe exercises include pendulum exercises in flexion or abduction or circular motion, posterior capsule stretch, scapular retraction, etc. (Chan, H. B. Y., Pua, P. Y., & How, C. H., 2017). In addition, exercise is essential in harmonizing Yin and Yang and regulating Qi to help clear and activate the meridians and collaterals (Sun, K., et al., 2001). 

 

All the TCM modalities highlighted above are offered here at Rapha Acupuncture in Newport Beach. We customize a personal treatment plan with each patient's body type to provide the best service and unique solution possible. 

References

Challoumas, D., Biddle, M., McLean, M., Millar, NL. (2020). Comparison of Treatments for Frozen Shoulder: A Systematic Review and Meta-analysis. JAMA Netw;3(12):e2029581. doi: 10.1001/jamanetworkopen.2020.29581. PMID: 33326025; PMCID: PMC7745103. 

Chan, H. B. Y., Pua, P. Y., & How, C. H. (2017). Physical therapy in the management of Frozen Shoulder. Singapore medical journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5917053/  

Chandran, K., Chandran, P., Arumugam, N., & Muthappan, S. (2021). Effect of Remote and Local Acupuncture Points on Periarthritis of Shoulder: A Comparative Study. Journal of Acupuncture and Meridian Studies, 14(1), 13–20. https://doi.org/10.51507/j.jams.2021.14.1.13  

Chi, L.M., Lin, L.M., Chen, C.L., Wang, S.F., Lai, H.L., & Peng, T.C. (2016). The effectiveness of cupping therapy on relieving chronic neck and shoulder pain: A randomized controlled trial. Evidence-based complementary and alternative medicine : eCAM. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814666/ 

Daily, J. W., Yang, M., & Park, S. (2016). Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: A systematic review and meta-analysis of randomized clinical trials. Journal of medicinal food https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5003001/ 

Hou, X., Xiong, W., Lin, X., Zhu, Y., Yang, R., Huang, J., Chen, Z., Ma, H. (2021). Auricular acupuncture for shoulder pain: A protocol for systematic review and meta-analysis. Medicine: - Volume 100 - Issue 17 - p e25666 doi: 10.1097/MD.0000000000025666 

Kim, B. & Park, H. (2020). The Effects of Auricular Acupressure on Joint Pain and Shoulder Range of Motion in Older Adults. Sŏngin Kanho Hakhoe chi, 32(3), 261–. https://doi.org/10.7475/kjan.2020.32.3.261 

Kim, Y. J. (2021). Acupuncture management for acute frozen shoulder: A case report. Clinical Case Reports. https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.5055 

Manske, R. C., & Prohaska, D. (2008). Diagnosis and management of adhesive capsulitis. Current reviews in musculoskeletal medicine, 1(3-4), 180–189. https://doi.org/10.1007/s12178-008-9031-6 

Meng, X., Xiu, W. C., Hu, X. Y., Jiao, R. M., Shi, L. J., Yang, J. W., Gang, W. J., & Jing, X. H. (2022). Zhongguo zhen jiu = Chinese acupuncture & moxibustion, 42(2), 227–230. https://doi.org/10.13703/j.0255-2930.20210820-k0002 

Robinson, C., Seah, K., Chee, Y., Hindle, P., and Murray, I. (2012). Frozen Shoulder. The Journal of Bone and Joint Surgery. British volume 94-B:1, 1-9 https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.94B1.27093  

Sun, K., Chan, K., Lo, S., & Fong, D. (2001). Acupuncture for frozen shoulder - HKMJ. Vol 7 381-91 https://www.hkmj.org/system/files/hkm0112p381.pdf  

Wang, L., Zhang, Y., Wang, Z., Gong, N., Kweon, T. D., Vo, B., Wang, C., Zhang, X., Chung, J. Y., Alachkar, A., Liang, X., Luo, D. Z., & Civelli, O. (2016). The antinociceptive properties of the corydalis yanhusuo extract. PloS one. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021270/ 

Zhao, H., Lou, Y., Zhou, T., He, J., You, X., Yang, A., Gong, W. (2022). Moxibustion plus Acupuncture for the Treatment of Poststroke Shoulder Pain: A Randomized Controlled Pilot Study. Complementary Medicine Research. https://www.karger.com/Article/Abstract/525155