Insights & Discussion
Our study provides evidence that acupuncture has a specific impact on frozen shoulder beyond the placebo effects that may not only be beneficial in reducing short-term pain perception, but may also have a positive long-term influence on the time course of recovery.
Primary adhesive capsulitis ("frozen shoulder") is a common disorder associated with pain and significant morbidity in humans worldwide. This first double-blinded (patient- and observer-blinded) study in patients with AC showed the efficiency of our special distal needling protocol by systematic combination of acupoints for immediate pain reduction. The study also confirmed the suitability of press tack needles and press tack placebos as an effective option for double-blind studies in acupuncture. The follow-up clinical observation with classical needle acupuncture confirmed that results obtained with the press tack placebos/press tack needles design can be transferred to classical needle acupuncture. Furthermore, conservative therapy that included acupuncture represented a superior effectiveness on the time course of recovery in AC patients compared with patients treated with conservative therapy alone in a standard clinical setting.
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Electroacupuncture may be more effective than manual acupuncture for managing frozen shoulder, with larger effect sizes in terms of pain, function, and response rate.
2022 Frontiers in Medicine Electroacupuncture for the treatment of frozen shoulder: A systematic review and meta-analysis Heo JW, Jo JH, Lee JJ, Kang H, Choi TY, Lee MS, et al.
Systematic Review Electroacupuncture Frozen Shoulder Shoulder Pain
This review included thirteen studies involving 936 patients. The EA group exhibited improvements in FS pain, function, and response rates over the manual acupuncture (MA) group. As an adjunct treatment, EA improved FS pain compared to the control treatments. No adverse effects were reported.
EA was found to be an efficacious method for treating FS in this review. The meta-analysis showed that EA led to a greater reduction of FS pain than MA did, although with a very low certainty of evidence. In comparison to MA, EA led to a superior degree of functional improvement in FS patients, with a very low certainty of evidence. In comparison to MA, EA enhanced the response rate of FS, again with a low certainty of evidence. Compared with WM used in isolation, EA plus WM reduced FS pain with a low certainty of evidence.
Acupuncture is safe and may be a cost-effective treatment for shoulder pain.
2022 Perspectives on Integrative Medicine Shoulder Pain and the Potential Role of Acupuncture: A Narrative Review of Clinical Practice and Treatment Guidelines Birch S, Lee MS, Kim TH, Alraek T
Practice Guideline Shoulder Pain
There were 131 statements recommending the use of acupuncture for shoulder pain across 12 subtypes of shoulder pain. The most common statements were for non-specific ‘shoulder pain.’ There were 11 statements against the use of acupuncture for shoulder pain and three subtypes of shoulder pain. The level of evidence in studies of acupuncture treatment for shoulder pain is low, therefore, further research is needed. Recommendations for the use of acupuncture for shoulder pain are increasing but lag behind those for other pain problems such as low back pain.
Massage combined with acupuncture can better improve the range of motion of joints and daily living ability of patients with frozen shoulder complicated with cervical spondylosis.
2021 American Journal of Translational Research Effects of massage and acupuncture on the range of motion and daily living ability of patients with frozen shoulder complicated with cervical spondylosis Liu M, Liu Y, Peng C, Wang H, Xu Y, Jiao S, et al.
Randomised Controlled Trial Frozen Shoulder Shoulder Pain
A total of 164 patients with frozen shoulder treated in our hospital from June 2016 to April 2019 were recruited and divided into a control group and an observation group. There were 100 cases in the observation group, all of whom were treated with massage combined with acupuncture. Another 64 cases were enrolled in the control group, all of whom were treated with acupuncture alone. The recovery of myodynamia, rating scale of the American Shoulder and Elbow Surgeons (ASES), score of American Spinal Injury Association (ASIA), ROM score, vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1), complication rate, total effective rate, and patient satisfaction were assessed.
After treatment, patients in the observation group had better recovery of myodynamia than the control group. They also had lower VAS scores, higher life function score and total ASES scores, higher ASIA scores, higher ROM scores, lower VCAM-1 and ICAM-1 expression, lower complication rate, higher total effective rate, and higher patient satisfaction.
Acupuncture has been shown to significantly improve pain, disability, and quality of life for patients with shoulder impingement syndrome.
2021 Journal of Acupuncture Research Acupuncture Treatment for Shoulder Impingement Syndrome: A Review of Randomized Controlled Trials Park JE, Kim WY, Lee SJ, Oh DY, Lee MC, Jeon MK, et al.
Review Article Rotator Cuff Injury Shoulder Pain
The research methodology involved a literature review of randomized controlled trials where acupuncture was used as an intervention for patients diagnosed with shoulder impingement syndrome. Relevant clinical studies were retrieved from several databases based on specific inclusion and exclusion criteria, and the interventions used, and results obtained were diligently analyzed. Six of these studies were chosen for an extensive review based on the stringent parameters defined.
The results of these six studies testify to the apparent efficacy of acupuncture as a treatment for shoulder impingement syndrome. Upon analysis, the acupuncture treatment group consistently demonstrated significant positive changes in metrics evaluating pain, disability, and quality of life. There was an observed decrease in evaluative indicators such as Shoulder Pain and Disability Index, Numeric Rating Scale, Visual Analogue Scale, and others, and a considerable increase in the scores of the self-reported questionnaires like UCLA, AL-score, EuroQol 5 Dimension, and more. One study even reported acupuncture's effectiveness to be on par with corticosteroid injections in terms of improvements in pain and quality of life measures. Notably, no major side effects from acupuncture were reported across the studies.
Acupuncture, in its various forms, shows significant potential in alleviating pain and improving shoulder function in patients with rotator cuff disorders.
2021 Journal of Acupuncture Research Acupuncture for Symptomatic Rotator Cuff Disease: A Systematic Review and Meta-Analysis Choi S, Lee J, Lee S, Yang GY, Kim KH
Review Article Rotator Cuff Injury Shoulder Pain
The participating researchers examined a multitude of sources, involving 12 electronic databases and 3 trial registries until November 2019, poring over any applicable randomized trial regardless of its language or date of publication. The research primarily focused on pain symptoms, the functionality of the shoulder, and the ratio of participants showing improvement within 12 weeks since the initiation of the trial. They adopted the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of evidence, while the included studies' bias risks were evaluated using the Cochrane risk of bias tool. Various types of acupuncture were evaluated, including manual acupuncture, dry needling, electroacupuncture, acupotomy, warm needle acupuncture and fire needle acupuncture, extracted from a total of 28 randomized trials involving 2,216 participants.
The results gleaned from these trials suggest that acupuncture could indeed have a significant impact on the relief of pain and the enhancement of shoulder function for patients suffering from rotator cuff diseases. However, discrepancies between the trials resulted in considerable heterogeneity. Despite this, no significant harm was observed amongst the patients. However, due to the level of uncertainty associated with the data and the partialness of the reports, the safety of acupuncture is still up for debate.
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