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Shoulder pain

Shoulder pain can make daily movements quite difficult. Lifting your arm, putting on a coat, taking something out of a closet, exercising or sleeping on the affected side can be painful. Sometimes the pain occurs suddenly after wrong movement, fall or injury. In other cases, symptoms gradually increase due to repeated stress, changes in muscles or tendons or prolonged muscle tension.

The pain may be on the front, side or back of the shoulder and sometimes radiate to the upper arm, neck or shoulder blade. Also stiffness, loss of strength and difficulty with upper hand movements can occur.

Acupuncture and Chinese herbal medicine can be used to reduce pain and support recovery. The treatment is tailored to the possible cause, the character of the pain, the motility and duration of the complaints.

Western disorders where shoulder pain may occur

Shoulder pain is a symptom and can have several causes. Common disorders and diagnoses are:

A specific condition does not always need to be diagnosed. Shoulder pain may also be present without one clear cause being identified.

Possible causes

Shoulder pain can be caused by muscles, tendons, mucus wallets, joint caps or joints around the shoulder. A fall, sudden movement or sports injury can cause immediate complaints. On repeated loads, many upper-handed work or sports can develop symptoms gradually.

Age-related changes in tendons and joints can also play a role. In a frozen shoulder, the joint cap is painful and less and less mobile. In addition, pain that is felt around the shoulder can come from the neck.

Long-term muscle tension can also contribute to symptoms, for example when the neck and shoulder muscles remain continuously tense during periods of stress.

How can acupuncture help with shoulder pain?

Acupuncture looks at the location and character of the pain, how the symptoms have arisen and what movements trigger the pain. Also radiant pain, muscle tension, stiffness, mobility and capacity for activity are included. The treatment can be adjusted during recovery.

Acupuncture may include:

In the event of movement limitation or injury, a gradual build-up of movement and capacity for activity remains important. Acupuncture can therefore be combined with physiotherapy, exercise therapy and targeted strength and mobility exercises.

How can Chinese herbal medicine help with shoulder pain?

Chinese herbs can be used in addition to acupuncture, especially when shoulder pain is present for a long time, regularly returns or is part of a broader grievance image. As herbs are taken daily, they can also provide support between acupuncture treatments.

Depending on the underlying pattern, Chinese herbal medicine may focus on:

The composition is tailored to your complaints and general health and can be adjusted during the treatment course. Herbs are not required for any type of shoulder pain; in a mainly local or mechanical complaint, the emphasis may be on acupuncture, movement and targeted exercises.

How does Chinese medicine view shoulder pain?

Within Western medicine, it looks at which structures or conditions can explain the shoulder pain, such as muscles, tendons, mucus wallets, the joint hairstyle or the shoulder joint. The traditional Chinese medicine (TCM) also looks at the nature of the pain and the circumstances that caused or continues to cause the complaint.

In case of pain symptoms, the meridians and the flow of Qi and Blood are particularly central. Meridians are seen within TCM as compounds through the body that circulates Qi and Blood. Multiple meridians run across the front, side and back of the shoulder and upper arm. Therefore, the precise location of the pain and possible appearance can help determine which meridians receive attention during treatment.

An important starting point within TCM is that pain occurs when the free flow in an area is obstructed. After overload, this disturbance can be relatively mild, while after a fall or other injury a stronger local stagnation may occur. Cold and moisture can also impede movement around muscles and joints according to TCM.

Some long-term shoulder complaints not only show pain, but above all stiffness and movement restriction in the foreground. TCM can therefore look at Dampness and Phlegm . These terms are used for accumulations that according to TCM can hinder normal movement and function. This may be relevant for a shoulder that is becoming stiffer and more difficult to move.

Long-term tension can also play a role. When stress comes together with tense neck and shoulder muscles and varying pain, the TCM will look into whether Qi's free movement is affected by this.

A recognizable combination of such characteristics is called a TCM pattern. Two people with the same Western diagnosis, for example a frozen shoulder, can therefore have different patterns and be treated differently.

Below are only the most common patterns discussed. Other patterns are possible and multiple patterns may occur at the same time. Not everyone with the same pattern has all the mentioned symptoms. The pattern is determined based on the overall picture of your symptoms.

What's a meridian?

What is a TCM pattern?

Most common TCM patterns for shoulder pain

Qi- and Blood stagnation

With Qi- and Blood stagnation, local flow around the shoulder is hampered. This often occurs with overload or when certain movements cause the same pain over and over again.

Common symptoms: local pain and tenderness, tension around the shoulder, pain with certain movements and a certain degree of stiffness or restriction of movement. Complaints may increase during or after tax.

Examples of Western disorders: rotator cuff symptoms, subacromial pain symptoms and other overload symptoms of muscles and tendons around the shoulder.

Blood stasis

In Blood stasis, local stagnation is stronger and usually more persistent. This pattern can occur after a fall, collision or other injury, but also when local shoulder pain remains present for a long time.

Common symptoms: sharp or stabbing pain, clearly defined pain spot, strong sensitivity to pressure and limited movement. The pain may also be present at rest or at night.

Examples of Western disorders: shoulder symptoms after trauma or surgery, long-term tendon complaints and chronic local pain after an earlier injury.

Wind-Cold-Dampness

According to TCM, cold and moisture can hinder the free movement around muscles, tendons and joints. This pattern fits especially with shoulder pain where temperature and weather conditions clearly influence the complaints.

Common symptoms: pain and stiffness that get worse in cold or humid weather, a heavy or stiff feeling in the shoulder, limited mobility and improvement by heat and quiet movement.

Examples of Western disorders: osteoarthritis and various prolonged muscle, tendon and joint problems in which cold and stiffness play a clear role.

Dampness and Phlegm

At Dampness and Phlegm there is a persistent obstruction of movement in the foreground. The shoulder can feel heavy and stiff and the freedom of movement can continue to decrease. This pattern often coincides with other patterns, such as Qi- and Blood stagnation.

Common symptoms: severe or dull pain, pronounced stiffness, clear restriction of movement and a heavy or blocked sensation around the shoulder. Sometimes swelling, tingling or numbness may also occur.

Examples of Western disorders: Frozen shoulder and prolonged shoulder complaints with strong stiffness and restriction of movement at the forefront.

Liver Qi-stagnation

With Liver Qi-stagnation, the movement of Qi according to TCM is less flexible. This pattern fits especially when stress, emotional stress and prolonged muscle tension clearly affect the symptoms. Often both shoulders and neck or jaw are tense.

Common symptoms: tense neck and shoulder muscles, nagging or oppressive pain, varying symptoms and worsening during periods of stress. Headache, jaw tension, irritability or restless sleep may occur at the same time. Movement, massage or relaxation can give relief.

Examples of Western disorders: non-specific shoulder pain and muscle-related neck and shoulder complaints in which tension plays a clear role.

Outlook

How quickly shoulder pain improves depends on the cause, duration and severity of the complaints and the extent to which the shoulder can still move and be loaded. Acute complaints after overload or mild injury can recover relatively quickly, while prolonged tendon symptoms, osteoarthritis or a frozen shoulder usually require more time.

In the initial phase, treatment is often done approximately once a week. For acute or severe symptoms, temporary treatment can be appropriate two to three times a week. When pain decreases and mobility and capacity for activity improves, the frequency can usually be reduced. These are guidelines; the course of treatment will be tailored to your situation.

For shoulder problems, movement is often an important part of recovery. Depending on the cause, targeted exercises for mobility, strength and capacity for activity may be required. Acupuncture can be combined with physiotherapy or practice therapy.

When is medical research important?

Most shoulder complaints have no serious cause, but some situations require medical assessment.

Allow the shoulder to be assessed in case of severe pain or clear movement restriction after a fall or accident, a visible position deviation or when you can suddenly barely use the arm. Also increasing power loss, clear sensational disturbances or a warm, red and highly swollen shoulder may be a reason for medical examination.

Even if new or unexplained shoulder pain worsens rapidly or does not improve as expected, it is wise to have the cause assessed.

Contact

Do you suffer from shoulder pain and want to know if acupuncture can help you?

During a first consultation, we will discuss your complaints, medical history and any underlying factors. On the basis of this, a treatment plan will be drawn up that matches your situation.

You can make an appointment directly online or contact us for more information.

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