Acupuncture Continuing Education

Acupuncture Reduces Shoulder-Hand Syndrome Pain

Acupuncture alleviates shoulder-hand syndrome (SHS), a complex regional pain syndrome of the upper limbs often caused by a stroke. SHS involves sudden swelling and extreme pain as a complication after the onset of hemiplegia. Needles applied to the shoulder are shown. The condition may also be referred to as reflex dystrophy syndrome. Researchers conducted a controlled experiment finding acupuncture effective in reducing pain and swelling of the shoulder and hand due to SHS. The total effective rate of acupuncture combined with infrared therapy was 97.10%.

A total of 126 patients with SHS were randomly divided into an acupuncture group and a control group. The control group underwent physical therapy and the acupuncture group received acupuncture combined with infrared laser therapy. Physical therapy sessions were conducted for the control group at a rate of twice per day. Each physical therapy session was 40 minutes in length. Physical therapy sessions were conducted over a 4 week period. For the acupuncture group, filiform needles were applied to the following acupoints:

  • Nei Guan, PC6
  • Yang Xi, LI5
  • Ren Ying, ST9
  • Chi Ze, LU5
  • Ji Quan, HE1

The reinforcing and reducing methods were applied with lifting and thrusting techniques. Acupuncturists checked with patients to ensure that needling methods induced a dull sensation in the arms. Acupuncture was performed once per day with a needle retention time of 30 minutes per session. Acupuncture was provided for a 40 day period.

One of the key acupoints used in the acupuncture point prescription was PC6. Acupuncture point PC6 is a luo point and is also a confluent point paired to acupoint SP4. Hand applying needles shown. According to Traditional Chinese Medicine (TCM) principles, this acupoint calms the heart and spirit, regulates qi, and suppresses pain. It is located 2 cun above the transverse crease of the wrist between the tendons of the palmaris longus and flexor carpi radialis on the anterior aspect of the forearm. A cun is approximately 1 inch. A cun is a special unit of length measurement used by acupuncturists and is relative to an individual’s physical size.

Infrared laser therapy was provided once per day for 4 weeks. Infrared laser therapy was applied for a total of 10 minutes per session to acupoints:

  • Jianyu, LI15
  • Jianliao, SJ14
  • Tianzong, SI11

The acupuncture group achieved an effective rate of 97.10%. The physical therapy group achieved an effective rate of 73.68%. Only 2.9% of acupuncture patients did not show any improvement. A total of 26.32% of physical therapy patients had no improvement. The results suggest that further research is warranted, including and investigation of the effectiveness of combining physical therapy with acupuncture and infrared laser therapy. Although the total effective rate of physical therapy and acupuncture individually is high, it may be possible to increase the therapeutic effectiveness per each patient with the combined approach. Future research can determine whether or not there is a synergistic or additive effect in combining the therapies.

Feng Yimo, Ma Sulan, Acupuncture combined with infrared acupoint irradiation and rehabilitation treatment of 126 cases of clinical observation on shoulder hand syndrome after stroke, Laser Journal, 2015, (4).

Acupuncture Continuing Education Credits