The Western Medical therapy in frozen shoulder is often problematic and Chinese acupuncture seems to be the treatment of choice as it is indicated by many clinical research trials worldwide
Frozen shoulder is one of the commonest disorders seen in acupuncture practice. The frozen shoulder is usually a degenerative and inflammatory process affecting the articular capsule and the soft tissues. According to the causes, frozen shoulder named as one of the followings:
However, frozen shoulder is known in Traditional Chinese Medicine as the "shoulder at the age of 50". The followings are the facts on frozen shoulder:
Frozen shoulder can be mild and self-limiting in its course, or it may become chronic and give rise to progressive degenerative changes. Generally, it is characterised by stiffness with limitation of movement and the presence of pain which may be acute, sub-acute or chronic. In mild cases, pain and stiffness may be relieved within a short period of time, with or without treatment, but the management of sub-acute and chronic cases is often unsatisfactory with drug therapy. Other physical treatments such as heat, massage and manipulation may be equally unsatisfactory.
It is evident that acupuncture therapy for frozen shoulder has the highest patient acceptance in preference to all other alternative methods of treatment. Frozen shoulder has three phases which may take up to 2 years to resolve or may be longer:
1. The freezing phase:
Although the patient is healthy, the history is usually showing a minor shoulder injury and presenting a gradual onset of shoulder pain and stiffness. Although all active movements are painful and restricted, the adhesions have not yet formed.
2.The frozen phase
The patient will have a pain-free, but experiencing muscle wasting due to no
movements at the gleno-humoral joint (i.e. disuse atrophy). This is because the adhesions are present in the joint capsule.
3.The thawing phase
In this phase the patient will have the shoulder movement gradually returns.
The western medical treatment of frozen shoulder consists of:
The Traditional Chinese acupuncture is regarded as an effective measure in aborting the signs and symptoms of frozen shoulder and also in preventing the future recurrence. Therefore, Acupuncture therapy can prove of benefit in medical practice for patients with clear medical diagnosis of frozen shoulder.
Our pilot clinical study in 1999 indicated that using acupuncture in the treatment of 31 patients with frozen shoulder showed marked improvement in 24 and improvement in 6. Patients with idiopathic or arthritic frozen shoulder responded better than those with post-traumatic aetiology. There was no relationship between response to acupuncture and age.
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Although this study involved no control group, the high level of improvement together with the author’s clinical experience suggests that acupuncture should be considered an effective option in the treatment of frozen shoulder; the more so since conventional medical therapy has a low expectation of benefit. Aetiology pathology and clinical management are described in both Western medical and traditional Chinese terms and details of acupuncture treatment methods are given.
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