Yi Song, L.Ac | Article

The Longtime Effect of Reoccurring Shoulder Pain

A 62 year old woman who had acupuncture treatments at HolliBalance Well-being Center several years ago came back for treatments of plantar fassciatis (heel pain). Upon examining, she mentioned that her right shoulder joint has been bothering her for over a year and she had quite a lot of pain just combing her hair in the morning. She said she had done physical therapy and the condition improved from its worst time but the pain from doing certain movements still lingers and hadn’t improved in the past six months. She explained that she hadn’t mentioned this issue previously because she was unaware that acupuncture could help improve her pain. However, after only two treatments the pain was noticeably gone and she could comb her hair without any pain.

Have you ever noticed the commonality of people around fifty years old (between forty-five to sixty-five years old) experiencing shoulder problems? At HolliBalance, we’ve had quite a few people come in with a wide range of shoulder complaints such as stiffness, inflammation, restriction and immobility of movement. This is known as the Rotator Cuff Syndrome or shoulder joint injury/inflammation. When it becomes severe and/or chronic, it is called Frozen Shoulder or adhesive capsulitis in Western Medicine. Frozen Shoulder develops because the chronic inflammation ‘freezes’ the muscle fibers so that the fibers can no longer glide smoothly to perform movements or contract to its full ability. Shoulders are major joints in the body that sustained many weights and activities. It also has several groups of muscles and ligaments connecting to the bones of the joints. It is very easy to have minor tear to muscle fibers or ligaments when certain weight is placed on it or extreme movement is used. Frozen shoulder or Adhesive Capsulitis develops as a result of improper treatment in minor shoulder pain, stiffness and inflammation, which causes restrictive and immobility of movement. Why is it that only the shoulders seem to be affected, but not other parts of the body?

In Chinese medicine, the Frozen Shoulder is referred to as “50’s shoulder”. This is because people at risk are usually aged around fifty years old. Thus, we commonly believe that the main reason behind shoulder issues is old age; we relate the deterioration of muscles and joints to the notion of naturally getting older. This is an accurate belief because aging does indeed bring on wear and tear to our joints and leads us to become less agile and lose flexibility and movement. Also, people who are older in age have succumbed to more injuries than younger people and we tend to overlook chronic shoulder pain that resulted from earlier injuries and overtime,it begins to take a toll on one’s shoulders.

In traditional Chinese Medicine, there are 12 main Channels or Meridians flowing throughout our body. The most important channel when it comes to nourishing ligaments in the shoulder joint is the large intestine channel. This channel connects the digestive system, provides nourishment to the muscles in the body. It starts from the radial side of the index finger through the back of the upper front edge of the shoulder wrapping around to the front part and back parts of the shoulder, travelling to the outer collarbone then to the lungs region continuing to the chest through the diaphragm down towards the superior top of the large intestine.

A minor shoulder injury is usually what initiates chronic conditions of the 50’s shoulder. When the injury does not heal correctly it can turn into different long-term chronic problems. When you examine the causes of 50’s shoulder from a Traditional Chinese Medicine perspective, it’s a decline of the Qi and blood in the Yang Ming channel. As we age, we have an inevitable decline in the movement of energy, known as Qi energy. The decline in energy as well as previous injuries make it prone to get blockages in the channel. These blockages decrease the circulation of energy and blood that are needed to help the shoulder heal correctly. This type of energy supports the blood and body fluids that nourish the body’s joints. The reason as to why Frozen Shoulder is most common among people aged 50 is because Qi energy flows less which declines the nourishment of the muscles and joints from the Yang Ming channel which decreases its healing and recovery abilities. This type of pain can make even the simplest tasks or any type of physical activity initiate shoulder injuries.

It’s commonly believed in Western medicine that the best treatment for this type of injury is to apply ice or cold compress to relieve swelling and to take over the counter pain killers. Some people also choose to ignore the pain until it fades away which they believe is natural healing. Once the pain decreases or completely fades, they believe that the injury has healed and they can continue on with their daily normal activities. This is a mistake. People don’t realize that the initial symptoms they suffered weren’t properly healed within the body correctly and so they can have reoccurring pains in the same area.

Shoulder injuries can perpetuate into further problems down the line if not properly cared for. Also the cases in which the injury was being left untreated can progress later on and exacerbate into more severe symptoms.

If you treat the shoulder issues early on you can eliminate and/or lessen the chances of having problems that lead to later conditions of 50’s shoulder.

Often times it’s the improper treatment that causes these conditions such as pain, reduction and constriction of range of motion and kinetics, or long term- chronic pain or immobility. Proper treatment of any shoulder injury is the key to prevent those conditions. There are a few advice that can be used for treatment of the pain.

#1: Do Not Use Ice

The number one advice is to only use ice within 24-48 hours of injury. Most times, when people’s injuries start off as minor pain, we don’t recommend using ice. This is because ice doesn’t give you the long-term healing you need; it only provides you with temporary numbness. Numbness isn’t a proper form of recovery; it only provides you with a temporary relief caused by the freezing sensation on your muscle. Ice is also detrimental to your recovery because it slows down circulation of the Qi energy in the Yang Ming channel.

#2: Use Heat + Herbal Pain Spray

Using heating pads for twenty minutes at least once a day will tremendously help with the pain. This is because heat will allow your body to promote circulation and the flow of Qi energy in the Yang Ming channel. Better circulation carries away the inflammatory molecules and waste accumulated area and allows for repair of the muscle. Herbal pain spray, when is combined with heat, penetrates deep in the muscle and joints, reduces the inflammation and allows healing of the muscles and ligaments.

#3: Stretching

Stretching is important to improve the condition of your injury. By knowing and using the proper stretching techniques, we can help reduce the inflammation in the joint. Frequent stretching of the joint allows the blockage to open up a little bit and improves the pain. It’s important to be aware that there are different levels and types of stretching that fit different aspects of the injury.

#4: Massage

Chinese therapeutic massage is an excellent and effective alternative in treating the cause of the frozen shoulder. Circulation is crucial in healing any type of injury. Massage should be done in conjunction with stretching; when a therapist is helping a patient through massage, it’s important that the therapist helps the patient with proper passive stretching so the patient can perform movements they’re unable to do by themselves due to the frozen shoulder. This is best done whilst the therapist is massaging the nodules to break them up.

#5: Acupuncture

Acupuncture is used in either the early stage of an injury or due to improper treatment that led to worsened chronic frozen shoulder. Acupuncture technique targets the specific affected channel and opening up the blockages while moving the Qi within one’s body. The movement of Qi leads to the nourishment which supports the healing process of the affected shoulder’s muscle and joints from inside deep within. In essence, the treatment altogether alleviates pain and helps to speed the healing process by moving the flow Qi (energy) and by dispersing any stagnation of the tissues and muscles.

In summary, it’s important to treat early stage shoulder pain as early as possible to prevent this pain from developing into a chronic condition. At HolliBalance Well-being Center, we’ve had patients come in who have tried physical therapy for an extensive period of time but they plateaued and didn’t regain their full range of motion. We’ve also had patients who had tried acupuncture but their therapists did not perform proper stretching during their acupuncture treatment so the recovery was not complete. We recommend that people experiencing shoulder pain try to use different therapies concurrently to get optimum results. For example, using heat and herbal spray together can help improve the condition better than using them separately. Similarly, massaging can only improve one’s condition if it’s done with proper passive stretching