(209) Q & A: Adhesive capsulitis

[HB KIM]

Q:  Does anyone have a special technique for the treatment of frozen shoulder other than the obvious ST38 or local points on the shoulder?


A:  Acupuncture for Frozen shoulder (Adhesive Capsulitis)

Frozen shoulder, or adhesive capsulitis, is a condition that causes restriction of motion in the shoulder joint. The cause of a frozen shoulder is not well understood, and it often occurs for no known reason. Frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue.

According to TCM, it can be Fluid deficiency at the joint.  Or, if one arm is used too much, it can cause a problem with the spine. If it's caused by spine disorder, you should treat the spine (root) first and shoulder joint (branch) later.

Diagnosis
1. If the arm can't be lifted up 90 degrees: It's a problem of the shoulder joint.  LI15 and SJ14 are good local points.
2. If the arm can't be lifted 90-150 degrees: It's a problem of scapula. Needle from below the scapula upward.
3. If the arm can't be lifted 150-180 degrees: It's a problem of the shoulder joint again. Consider the shoulder and pectoralis major muscle, latissimus dorsi muscle, and musculus serratus anterior.

TCM Acupuncture
1. Bleeding technique: Palpate the spine at the DU channel from the top down, and bleed tender spots. Bleed Hua Tou Jia Ji at T4 and LI15.
2. Distal Points: If it's a problem of the shoulder, use SI3, SJ2, SJ3.
3. Local points: LI15, SJ14, SI11, SI12, SI13, SI14, SI15, GB21, UB41
Esp. SI12, use the healthy side first and then the affected side.
4. If the patient can't touch their own back, use LI14.  If they can't wrap their arm over the top of the head and touch the jaw on the opposite side, use SI10.
5. Major herbs: Jiang Huang, Hai Tong Pi

Master Tung Acupuncture
1. Tian Huang and Tian Huang Fu (SP9 area), esp. when a patient can't touch their own back, or can't wrap their arm over the top of the head and touch the jaw on the opposite side, then add SI11.
2. If the problem is that they can't abduct the arm laterally: Ce San Li, Ce Xia San Li (ST36 on GB channel area)

Exercise
Of course, the patient should be encouraged to regularly do appropriate stretching exercises.  Also, regular application of hot packs or hot baths are helpful.