Electroacupuncture (EA) is an effective addition to exercise for the treatment of chronic shoulder pain. In a single-blind, randomised trial in Hong Kong, 60 patients were assigned to receive either active or sham electrical stimulation of acupuncture points on the wrist in addition to standardised neck exercises. Active or sham EA was given for 30 minutes twice weekly over a period of four weeks and a 30 minute program of standardised neck exercises performed simultaneously. One month post treatment 38.9% of the active EA versus 8.3% of the sham EA group reported pain reduction greater than 50% on a numerical rating scale. (Electrical acustimulation of the wrist for chronic neck pain: a randomized, sham-controlled trial using a wrist-ankle acustimulation device. Clin J Pain. 2009 May;25(4):320-6).

An American single-blind randomised, controlled trial randomised 31 subjects into one of three treatment groups: individualised TCM acupuncture; fixed standard acupuncture points conventionally used for shoulder pain; and non-penetrating sham acupuncture. Subjects received 12 treatments over six weeks. After six weeks of treatment, the mean total Shoulder Pain and Disability Index score improved in all three groups, but the change was clinically significant (>=10 points) only in the two verum acupuncture groups (-20.3 and -20.4, respectively, versus -6.5 in the sham group). No difference was found between the individualised acupuncture and standardised acupuncture treatments. (Efficacy of acupuncture as a treatment for chronic shoulder pain.J Altern Complement Med. 2009 Jun;15(6):613-8).

A multicentre randomised controlled trial conducted in Spain has found that single-point acupuncture in association with physiotherapy improves shoulder function and alleviates pain better than physiotherapy alone. 425 patients with a clinical diagnosis of unilateral subacromial syndrome received 15 sessions of physiotherapy over three weeks and were randomised to additionally receive, once a week, acupuncture or mock TENS (transcutaneous electrical nerve stimulation). The mean score on the Constant-Murley Shoulder Outcome Score increased by 16.6 points in the acupuncture group, compared with 10.6 points in the control group, and the mean difference between the two groups was statistically significant. This improvement was accompanied by a reduction in painkiller consumption. By the end of the treatment, 53% of the patients in the acupuncture group had decreased their consumption of analgesics, compared with a corresponding 30% in the control group. (Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial. Rheumatology (Oxford). 2008 Apr 10 [Epub ahead of print]).

One hundred and thirty patients with shoulder pain (cuff tendonitis, bicipital tendonitis, capsulitis etc.) were randomly assigned to receive either eight weekly true acupuncture treatments (local and distal points plus electro-acupuncture) or the same number of non-penetrating sham treatments (using a ‘stage dagger-type retracting placebo needle) plus sham electro-acupuncture. Blinded assessment by an independent assessor was made at seven weeks, three months and six months from the start of treatment. The pain visual analogue scale (VAS) score fell by 43% in the acupuncture group compared to 20% in the controls by the seventh week, an effect which was maintained at both subsequent assessments. Similar improvements were recorded in the Lattinen Index, pain and disability, range of movement, analgesic consumption and quality of life scores. (Pain 2004; 112: 289-98).

In a Hong Kong study, 35 patients with frozen shoulder were randomly assigned to an exercise group or an exercise plus acupuncture group. Mobility, strength and pain were assessed (blind) at outset, after 6 weeks and at a 20-week follow-up. The acupuncture protocol consisted of deep (2.5 cun) contralateral needing of the extra point Zhongping (1 cun inferior to Zusanli ST-36, midway between the tibia and fibula) with one minute of lifting, thrusting and rotation manipulation repeated three times during a 20 minute retention to produce strong deqi . The patient was asked to exercise the shoulder during the treatment. Improvement scores (measured by the Constant Shoulder Assessment) showed significantly greater improvement in the acupuncture group (76.4% versus 39.8%) at 6 weeks, and these were maintained at follow-up (77.2% versus 40.3%). (Hong Kong Med J 2001;7:381-91).


From: The Journal of Chinese Medicine