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Seattle/Shoreline Acupuncture and Moxibustion: The Treatment of Frozen Shoulder Syndrome (Adhesive Capsulitis) with Acupuncture and Moxibustion.

If you live in the Seattle/Shoreline area and are suffering from frozen shoulder syndrome, there is an excellent chance I can help you be pain free and restore normal range of motion (R.O.M.) and function to your shoulder.

The treatment of frozen shoulder syndrome also referred to as Adhesive Capsulitis with acupuncture and moxibustion is sighted as being very effective and helpful (1) with pain reduction and R.O.M.

Frozen Shoulder is a disorder of the shoulder capsule, the connective tissue surrounding  the glenohumeral joint of the shoulder. It becomes inflamed and stiff, greatly restricting the motion and often causing chronic pain.

Cause

It’s an ailment that most commonly affects those over forty years of age, and  women seem to have this more than men. The causes of frozen shoulder can very from trauma due to fractures and ligament and tendon tears. Most of the time there is no cause for frozen shoulder. Risk factors include

  • Cervical disc desease of the neck
  • shoulder injury
  • shoulder surgery
  • diabetes
  • open heart surgery
  • thyroid problemsimages

 

Presentation

Movement of the shoulder is severely restricted with progressive loss of both active and passive range of motion (R.O.M.). The condition is sometimes caused by injury, leading to lack of use due to pain, but also often arises spontaneously with no obvious preceding trigger factor.  Rheumatic disease progression and recent shoulder surgery can also cause a pattern of pain and limitation similar to frozen shoulder.

In frozen shoulder, there is a lack of synovial fluid, which normally helps the shoulder joint , a ball and socket joint, move by lubricating the gap between the humerus ( upper arm bone)  and the socket in the scapula (shoulder blade). The shoulder capsule then thickens, becomes inflamed and tightens due to bands of scar tissue (adhesions) that have formed inside the capsule. As a result, there is less room in the joint for the humerus, making movement of the shoulder stiff and painful. It is this restricted space between the capsule and the ball of the humerus that distinguishes adhesive capsulitis from a simple stiff shoulder.

Prevention

The best preventive measure is to keep the shoulder moving, doing intelligent movement that encourages full range of motion in all directions (adduction, abduction,flexion, rotation and extension.

Signs and diagnosis

The one most presenting sign of a frozen shoulder is that the joint becomes  so tight and stiff one is not able to carry out simple movements.  Along with a marked decrease in abduction, patients see a sever decrease in external rotation of the shoulder.

The normal course of a frozen should has generally three stages:

  • Stage one: The “freezing”, painful stage , which can last up to 6  weeks to nine months and the patient has a slow onset of pain. As pain worsens, the shoulder loses motion.                 frozen_shoulder
  • Stage two: The “frozen” or adhesive stage is marked by a slow improvement in pain, but the stiffness remains. This stage generally lasts 9 months.
  • Stage three: The “thawing” or recovery, when shoulder motion slowly returns to normal. This can take 5 to 26 months.

 

Treatment with Acupuncture, Moxibustion, Massage and Physical Therapy

Janet Travell, the author  of Myofascial Pain and Dysfunction: The Trigger Point Manual, speaking on the medical literature on frozen shoulders says, “When so many authors agree that the cause of a disease is enigmatic, there is good reason to expect that a major etiologic factor is being overlooked.”

What she is referring to here are trigger points lying in the subscapularis muscle. By needling these trigger points and motor points on the belly of the muscle, acupuncture can eliminate these trigger points, thus also eliminating frozen should once and for all. Acupuncture offers a safe and effective alternative to the common temporary  treatments of pain killers, cortisone shots and surgery.When an acupuncturist inserts an acupuncture needle (extremely fine,  pre- sterilized stainless steel needle) into the trigger point/motor point of the muscle, it cause the muscle to fasciculate (involuntary muscle contraction and relaxation) that releases the muscle fibers… I would not describe this as painful, however, it is more like a twitch or a brief  “charlie horse” in the muscle. While being extremely effective in eliminating shoulder pain, having these trigger points needled requires that the acupuncturist palpate somewhat forcefully in side the underarm to access the muscle. Other muscles that maybe involved would be the semi-spinatus and the infra-spinatus on the posterior of the scapula.

Traditional diagnosis and channel therapy are of course at the root of the treatment. See picture  here.

Also quite effective is Physical Therapy. A good PT can not only do good manual therapy, which is often needed, but can also help you with posture and movement, give  beneficial exercises and stretches to do at home. I send all of my patients to Stretch Physical Therapy (www.stretchpt.com)

Wolfgang Bolley and his staff of excellent therapist can further assist you  in achieving your goals of recovery.

Western Medicine does not have a lot to offer in treating this condition other than pain killers, cortisone injections and surgery. Acupuncture and physical therapy have been proven effective forms of treatment for this disorder.

 

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