Acupuncture Continuing Education

Acupuncture Found Effective For Shoulder Pain Relief

 acupuncture continuing ed LI15 TB14

Acupuncture is effective for relieving chronic shoulder pain. Meiji University of Integrative Medicine (Kyoto, Japan) researchers find true acupuncture more effective than sham acupuncture for the relief of chronic shoulder pain CSP. In another study by Shi et al., acupuncture combined with Mulligan Manual Therapy (MMT) relieved rotator cuff injuries and demonstrated superior patient outcomes to using MMT alone.

Kazunori et al. (Meiji University of Integrative Medicine) conclude that acupuncture is safe and effective for the treatment of CSP. Two groups were compared. One group received true acupuncture, and the other group received sham acupuncture. The true acupuncture treatment group outperformed the sham control group in terms of pain reduction and functional improvement. The results were measured by the visual analogue scale (VAS) score and Constante-Murley score (CMS). [1] Learn more about acupuncture continuing education online at acupuncture CEUs.

The study involved 18 voluntary patients from the Meiji University of Integrative Medicine Hospital. Inclusion and exclusion criteria were the following:

  • Shoulder pain lasting for 6 months
  • Insufficient response to the medications prescribed by their orthopedic specialist
  • An average pain score of 50 mm or on a 100 mm visual analogue scale (VAS)
  • Age between 40 years and 70 years
  • No osteoarthritis of the glenohumeral joint or systemic bone and joint disorder (e.g., rheumatoid arthritis)
  • No history of shoulder surgery
  • No other current therapy involving analgesics
  • Not received acupuncture in the last 6 months

Patients with major trauma or systemic diseases were excluded from the study. All patients selected were randomly divided into two groups, a true acupuncture treatment group and a sham control group, with 8 patients in each group. There were no statistically significant differences between the two groups in terms of age, disease, pain duration, VAS, or drug use for patients initially admitted to the study.

One question we frequently receive at HealthCMi is, “why are the sample sizes small?” This is a simple matter of funding. In the HealthCMi newsroom, there are numerous studies with sample sizes exceeding 10,000 patients. However, most funding is more modest and sample sizes are limited by resource restrictions. Fortunately, topics such as this have been covered in research in many large and small studies. The sheer number of independent studies showing the benefits of acupuncture for shoulder pain relief allows us to draw evidence based conclusions. Next, we take a look at what the researchers found in this investigation and the methodology used in the study design.

The true acupuncture group received acupuncture treatment at myofascial trigger points, many of which were ashi points. First, an acupuncturist (with 4 years of acupuncture training and 3–10 years of clinical experience at a minimum) examined muscles of the neck and superior limb to identify trigger points. Then, a 0.2 mm x 50 mm disposable needle was inserted into each acupoint to a maximum depth of 5–15 mm. The sparrow pecking technique was applied to elicit a local muscle twitch response. The needles were retained for 10 minutes. This study stands out from other research in that the retention time was less than 15 minutes.

For the sham acupuncture group, a specially developed sham needle simulated penetration of the skin. The needles did not penetrate the skin and had a round tip. A simulation of needle extraction was performed after 10 minutes by touching the patient and noisily dropping needles into a metal case. To facilitate blinding, eye masks were used during treatment for both groups.

Outcomes were measured immediately before the first treatment and at weeks 1, 2, 3, 4, 5, 10, and 20 after the treatment. For the true acupuncture group, the VAS score decreased significantly 5 weeks after the treatment, while the CMS score increased significantly at the same time point. Comparison between the two groups demonstrates a significant difference. The researchers conclude that “compared with sham acupuncture therapy, true acupuncture is more effective for the treatment of chronic shoulder pain.”

Shi et al. from the Shanghai Jiaotong University Affiliated Renji Hospital investigated the effects of electroacupuncture and MMT on rotator cuff injuries. [2] Rotator cuff injury is a common cause of CSP. MMT is a physical therapy technique used to treat musculoskeletal injuries. The researchers determined that the combination of both modalities is a more effective treatment protocol than using only MMT. Results were measured by the VAS, the UCLA shoulder rating scale, the Shoulder Pain and Disability Index (SPADI), and the Range of Motion for Shoulder (ROM).

The following points were selected for the electro-acupuncture treatment:

  • LI14 (Binao)
  • LI15 (Jianyu)
  • SI9 (Jianzhen)
  • SJ14 (Jianliao)
  • SI11 (Tianzong)
  • Extra points

Upon disinfection, a 0.25 x 40 mm disposable needle was inserted into each point to a standard depth. After achieving a deqi sensation, the ping bu ping xie (mild tonifying and attenuating) technique was applied. Then, electroacupuncture was applied to Jianyu, Jianzhen, Tianzong, and Jianliao using a continuous wave (100 Hz, <3 mA). Total needle retention time was 30 minutes.

After treatment, the VAS score in both groups decreased significantly, and the score of the treatment group was significantly lower than that of the control group. After the treatment, for both groups, the UCLA score significantly increased, while the SPADI score significantly decreased; the UCLA score of the treatment group was significantly higher than that of the control group, and SPADI of the treatment group was significantly lower than that of the control group . The ROM (degree of abduction and lateral rotation) in both groups increased significantly from scores prior to treatment. Also, the degree of abduction and lateral rotation of the treatment group was significantly higher than that of the control group. Results indicate that acupuncture with MMT is more effective than using only MMT.


[1] Kazunori I,Shingo S,Shunsaku S,Yuki N,et al,Hiroshi K. (2015). Randomized trial of trigger point acupuncture treatment for chronic shoulder pain: a preliminary study. Journal of acupuncture and meridian studies, 7(2).
[2] Shi YM, Yu L, Mao JJ, et al. (2019). Effect of electroacupuncture combined with joint mobilization on pain and joint function of patients with rotator cuff injury. World Journal of Integrated Traditional and Western Medicine, 14 (11): 1575-1578.


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