Shoulder pain and dysfunction are common complaints that significantly impact daily activities and overall quality of life for millions of Americans each year. Depending on how you like to count, about 20 different bones, muscles, tendons and ligaments attach to the shoulder joint. Considering this fact and how much we use our shoulders for everyday activities, it’s no surprise that shoulder pain and limited shoulder mobility are common complaints. Since the shoulder is connected so closely with the neck, spine and jaw, shoulder tension or misalignment can be a hidden factor contributing to pain and dysfunction in those areas as well.
At Mind + Body Acupuncture, we integrate acupuncture, Tuina massage, cupping and Chinese herbal medicine with modern techniques to provide effective relief and improved function for anyone suffering with shoulder pain, tightness, weakness and/or stiffness. Starting with a complete physical assessment, our practitioners work to find the root causes of pain and dysfunction and get you feeling better.
Common causes of shoulder pain we treat in clinic include:
Poor Posture: leaning over a desk or workbench can lead to muscle imbalances and strain on the shoulder.
Repetitive Movements: Activities that involve repeated shoulder movements, such as lifting or throwing, can lead to overuse injuries. This is a common sports and workplace cause of shoulder pain and injury.
Carrying Heavy Bags: Wearing heavy bags on one shoulder can cause stress on one side and lead to shoulder pain and injury.
Sedentary Lifestyle: Lack of movement can weaken shoulder muscles, making them more susceptible to pain and injury.
Chronic Tension: often due to stress and combined with other factors on this list, chronic tension leads to shoulder pain and dysfunction that can become severe.
Injuries: Tears or inflammation in the rotator cuff tendons can cause pain and restricted movement. Depending on the severity of the tear, your doctor may recommend surgery to repair the rotator cuff. Should you need surgery, keep in mind that acupuncture and herbs are highly effective in accelerating recovery from surgery, reducing inflammation, minimizing scar tissue and improving tissue repair.
Frozen Shoulder (Adhesive Capsulitis): This condition leads to stiffness and pain due to the thickening of the shoulder capsule. Most common in those over age 45, this condition can be extremely painful and may take months to resolve. Studies show that getting early treatment with acupuncture significantly speeds up recovery.
Bursitis & Tendonitis: Inflammation of the tendons or bursae (small fluid-filled sacs) that cushion the shoulder joint causes pain. Acupuncture allows the inflammation to be cleared without having to further irritate the already inflamed tissues around the shoulder.
Arthritis: Osteoarthritis and rheumatoid arthritis can affect the shoulder joint, leading to pain and decreased mobility, joint deformity and swelling, and muscle loss.
Shoulder Dysfunction in Chinese Medicine
In Chinese medicine, all pain, including shoulder pain, is understood to be caused by a lack of proper flow of Qi and Blood in the acupuncture channels and body tissues. This lack of flow leads to stagnation, pain, inflammation, and joint dysfunction that limits range of motion and stability of the shoulder.
Chinese medicine theory explains that because joints are such high traffic zones, where the many structures that comprise the physical manifestations of the acupuncture channels (skin, fat, muscles, tendons, ligaments, blood vessels, nerves, bones and fascia) all interface in complex ways. Due to the high amount of Blood, Qi and other vital substances needing to move through these relatively tight spaces, joints are more prone to developing issues of Qi and Blood stagnation. This provides a logical basis for why joints tend to be more prone to injury and dysfunction than other areas of the limbs and body.
In addition to local Qi and Blood stagnation, other factors that contribute to shoulder pain, stiffness and loss of function include:
Invasion by External Pathogens: Chinese medicine recognizes six pathogenic evils (六邪): Wind, Heat, Cold, Dampness, Dryness, and Summer Heat (also called Damp Heat). Any one or combination of these factors can penetrate the body, obstructing the flow of Qi and causing pain. This is most likely to happen when there is pre-existing weakness of the body or of a particular channel, which allows the pathogen an opportunity to get inside the body OR when we are exposed to these factors in the external environment for too long or in an extreme way the body isn’t accustomed to.
Internal Syndromes: The Six Evils (六邪) can also be generated inside the body when there is imbalance of healthy Qi. This may be due to poor or irregular diet, excessive emotional strain, overwork without adequate rest, aging, and/or exposure to toxins in the environment. Keep in mind that overworking includes physical, mental and emotional overwork.
Over time, these factors produce weakness in the Liver, Kidney, or Spleen systems in particular and lead to insufficient nourishment of the muscles and joints, resulting in pain.
The Spleen rules the muscles, so Spleen deficiency is often characterized by muscle weakness, loss of tone, atrophy, loose and flabby muscle tissue, dull, achy pain and difficulty in building muscle tissue despite adequate diet and exercise. Poor appetite, fatigue, brain fog, low iron and weak immune system may also be present.
The Liver rules the tendons and sinews, so when it is weak or overstrained there is tightness, inflexibility, rigidity and “creakiness,” of the joints. This is a common presentation for “frozen shoulder,” and injuries from overexertion combined with improper rest and recovery. Tension from stress can also be a major contributor since the Liver system is sensitive to stress. Eye and vision problems, depression, anger/irritability, digestive problems and sleep disorders may also be present.
The Kidney rules the bones, and is chiefly implicated when there is bone loss due to osteoarthritis and osteopenia/osteoporosis. This can lead to joint deformity, pain, loss of function, and limited range of motion. Pain and/or weakness of the back and knees, tinnitus, hearing problems, urinary issues, low libido and hormone imbalances may also be present.
How We Can Help: Treating the Shoulders with Acupuncture & Herbs
Acupuncture and herbs are excellent options to relieve pain, improve range of motion, boost joint stability and most importantly, address the underlying causes of shoulder joint pathologies.
Acupuncture works by rebalancing the vital energy, or Qi, of the body. Our patients frequently report that in addition to improvement in shoulder pain and mobility, acupuncture and herbs improve sleep, reduce stress and irritability, alleviate anxiety, and boost energy and stamina.
Specifically, acupuncture helps alleviate shoulder pain and improve mobility by stimulating the release of endorphins and other neurotransmitters that help reduce the perception of pain, reduce inflammation and improve the delivery of nutrients to the affected area. Needling specific points relaxes tight muscles and relieves spasms to improve range of motion. Acupuncture also directly regulates the central nervous system, reducing pain signals and promoting healing.
While treatment plans are tailored to the individual patient, we’ve included some examples of acupuncture points commonly used to treat shoulder joint pain and dysfunction:
Large Intestine 15 (Jianyu, 肩髃): Located on the anterior shoulder, between the acromion of the clavicle and the head of the humerus. Indicated for many types of shoulder pain, opens the meridian to allow healthy flow of Qi and Blood, treats stiffness and immobility of the shoulder joint.
Small Intestine 10 (Naoshu, 臑俞): Located on the back of the shoulder, near where the back of the head of the humerus (main bone of the upper arm) fits into the shoulder joint. Helps release tension and pain of the joint, useful for swelling and weakness of the shoulder and arm.
San Jiao 14 (also called Triple Burner 14, Jianliao, 肩髎): On the posterior shoulder, just below the posterior side of the acromion of the clavicle, at the insertion of the posterior deltoid. Often used to alleviate shoulder pain, expel pathogenic Dampness from the channel, and benefit the shoulder.
Stomach 38 (Tiaokou, 条口): Midway down the lower leg, slightly lateral to the tibia. Excellent for shoulder pain, stiffness and in particular for frozen shoulder (adhesive capsulitis) due to Wind-Cold-Damp invasion and Liver and Kidney deficiencies.
Large Intestine 4 (Hegu, 合谷): Located on the back of the hand between the base of the thumb and index finger. It is included in nearly every acupuncture point protocol for pain as it is strongly able to modulate the pain response via activation of the central nervous system. It also activates the Large Intestine channel which runs through the anterior shoulder. This point is contraindicated in pregnancy.
Gallbladder 34 (Yanglingquan, 陽陵泉): Found on the outer aspect of lower leg just below the head of the fibula, this point is known as the Meeting Point for all the body’s tendons and sinews. In addition, the Gallbladder channel runs over the crest of the shoulder, so this point is doubly effective for treating shoulder pathologies.
What About Other Therapies?
If you’ve tried a variety of treatments for shoulder pain, joint dysfunction or instability without getting results, you may be wondering what sets our treatments apart from others.
At Mind + Body Acupuncture & Wellness, we are proud to provide comprehensive care that includes various modalities in addition to acupuncture. We create personalized treatment plans that combine acupuncture and herbal medicine with other modalities as needed to address both the symptoms and root causes of shoulder pain. This integrative approach ensures comprehensive care and the best possible clinical results.
Tuina is a form of Chinese therapeutic massage that involves various techniques to stimulate acupoints, mobilize joints, and improve the flow of Qi and blood. It is particularly effective for shoulder pain. Research indicates that Tuina massage can reduce pain and improve function in patients with shoulder conditions such as frozen shoulder and cervical spondylosis (PMID 34017443).
Cupping therapy is used to help decompress tissue and release tension and tightness in the fascia to improve range of motion and reduce pain.
Moxibustion therapy, the practice of burning herbal substances at acupuncture points to warm and strengthen the body, is effective to improve energy and stamina, relieve pain, speed tissue repair and promote healing.
Electrical stimulation applies micro-current to acupuncture needles to relieve pain and accelerate tissue repair, making it useful for treatment of pain following surgery, traumatic injury, repetitive stress injury, sports injury, arthritis, tendinitis and more (to learn more check out our blog post on electrical stimulation acupuncture).
Chinese herbal medicine involves the use of specific plants and minerals to treat underlying imbalances causing shoulder pain. Some examples of herbs used for shoulder pathologies include:
Yan Hu Suo (Corydalis Root): Known for its analgesic properties, it helps to relieve pain by moving Qi and blood and relaxing smooth muscle.
Jiang Huang (Turmeric Rhizome): With anti-inflammatory and analgesic properties, this herb can help to alleviate pain and swelling. In Chinese herbal medicine it is particularly known for its beneficial effects on the shoulder joint.
At Mind + Body Acupuncture, our experienced practitioners are dedicated to providing compassionate, personalized support and effective treatments to provide pain relief and promote deep, lasting healing.
If you’re ready to take that load off your shoulder (or shoulders) for good, we are here to help! Visit www.mindplusbodyacu.com/services to book today.