Is Acupuncture the Best Alternative Treatment for Frozen Shoulder?

Dr.Emad Tukmachi, MBChB, PhD(London), DTM(Dublin November 21, 2013

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The Western Medical therapy in frozen shoulder is often problematic and Chinese acupuncture seems to be the treatment of choice as it is indicated by many clinical research trials worldwide.

Frozen shoulder is one of the most common disorders seen in acupuncture practice. The frozen shoulder is usually a degenerative and inflammatory process affecting the articular capsule and the soft tissues.  According to the causes, frozen shoulder named as one of the followings:

·                     periarthritis

·                     adhesive capsulitis.

·                     pericapsulitis or obliterative bursitis.                                  

However, frozen shoulder is known in Traditional Chinese Medicine as the "shoulder at the age of 50". The followings are the facts on frozen shoulder:

·         Frozen shoulder affects more women than men and over 50 years old. The clinical picture of this condition is characterised by pain and stiffness (reduction of passive and active movements).

·         The cause of frozen shoulder is unknown, but the onset is gradual and associated with previous history of minor shoulder injury.

·         In majority of frozen shoulder cases, it is unilateral but it can be bilateral.

·         Frozen shoulder can create secondary muscle spasm in pectoralis and biceps muscles.

Frozen shoulder can be mild and self-limiting in its course, or it may become chronic and give rise to progressive degenerative changes. Generally, it is characterised by stiffness with limitation of movement and the presence of pain which may be acute, sub-acute or chronic. In mild cases, pain and stiffness may be relieved within a short period of time, with or without treatment, but the management of sub-acute and chronic cases is often unsatisfactory with drug therapy. Other physical treatments such as heat, massage and manipulation may be equally unsatisfactory. It is evident that acupuncture therapy for frozen shoulder has the highest patient acceptance in preference to all other alternative methods of treatment.

Frozen shoulder has three phases which may take up to 2 years to resolve or may be longer:

The freezing phase:

Although the patient is healthy, the history is usually showing a minor shoulder injury and presenting a gradual onset of shoulder pain and stiffness. Although all active movements are painful and restricted, the adhesions have not yet formed.

The frozen phase:

The patient will have a pain-free, but experiencing muscle wasting due to no movements at the gleno-humoral joint (i.e. disuse atrophy). This is because the adhesions are present in the joint capsule.

The thawing phase:

In this phase the patient will have the shoulder movement gradually returning.

The western medical treatment of frozen shoulder is consists of:

1.            Drug therapy (Local cortison injection), non-steroidal anti-inflammatory and pain killers.

2.            Manipulation under anaesthesia.

3.            Physiotherapy.

The Traditional Chinese acupuncture is regarded as an effective measure in aborting the signs and symptoms of frozen shoulder and also in preventing future recurrence. Therefore, Acupuncture therapy has a proven benefit in medical practice for patients with clear medical diagnosis of frozen shoulder.