Shoulder Pain

By Li Hua, L. Ac TCMD.

Shoulder pain generally includes shoulder joint pain, and shoulder muscle pain. Because the pain is around shoulder area, it is called shoulder pain. Traditional Chinese medicine (TCM) thinks the shoulder pain is due to the stagnation of Chi and blood, or attacked by wind, cold, dampness, or phlegm, which can block the meridians (the Chi channel) and lead to limited movement of the shoulder. TCM classifies it in “Bi syndrome”. Shoulder pain often happens to the people around 50 years old. It is also called “fifty shoulder” in China. Since the shoulder pain caused by different reasons, different pathogenesis, different environments, patients’ body conditions are different, the treatment plan and method are different.

I have summed up 4 common kinds of shoulder pain in clinic. The first kind of shoulder pain is due to wind and cold. In traditional Chinese medicine, it is mentioned that one of the pathogenic factors is six exogenous factors, which includes wind, cold, summer heat, dampness, dryness and fire. This is a general term for the six climatic conditions. Human beings live in nature and have certain adaptability to various climatic variations, so the six normal natural factors cannot make people contract pains. But if the climatic variations are too unusual, the six natural factors will affect the human body and cause pains. When the shoulder is attacked by the wind and cold, the muscle around the shoulder is aching. This kind of shoulder pain is not very serious. The course of problem is shorter. The pain level is low. The character of the pain is aching or secret anguish, which do not limited the movement of upper limb. The range of the pain may only be around the shoulder; or pin down the connected scapula and upper back after the back of shoulder is affected; or if the pain is in the front of the shoulder, usually there may be a feeling of contraction around neck and upper arm. Patient may have cold feeling around pain area and will have the pain relieved if putting heat pat on. The tongue covers with white coating. The pulse is superficial. Acupuncture with cupping is recommended.

The second kind of shoulder pain is due to wind and dampness. The shoulder is not only pain, but also has heavy or distend feeling. The pain is not moving. It is not convenient to move the shoulder. The muscle may be numbness. The tongue covers with thin white coating. The pulse is superficial and retarded. The treatment is suggested to use acupuncture and TuiNa.

The third kind of shoulder pain is due to retention of phlegm and dampness. Retention of phlegm, in traditional Chinese medicine, is pathological products in the body, which can be concrete and formless. It can form in the course of pain. It is also one of pathogenic factors. This kind of shoulder pain is serious. The course of the pain is longer. Even the function of the shoulder joint is normal, because moving can lead to more pain. For long time without recovering, the shoulder joint is locked. The patient may have cold feeling around the shoulder. The heat can temporarily reduce the pain. The ice can make the pain worse. After that, the pain and cold feeling will be the same as before. Since the pain level is high, generally disturbed the sleeping, eating and normal working. The patients commonly combine with the deficiency of Chi, such as, spontaneous sweating, short breath, easy tiredness, or frequent catching a cold etc. The tongue is pale red, covers with thick white coating. The pulse is wiry and smooth, or wiry and thready. The treatment is advised to use acupuncture, cupping, TuiNa and Chinese herbs and special exercise for shoulder function.

The forth kind of shoulder pain is due to blood stasis. This kind of shoulder pain comes from trauma, such as twisting, falling down, accident pulling etc. The pain may be severe or twinge. The tongue is red and purple or with purple spots. The pulse is thready and uneven. If the pain is not recovered for long time, no matter what kinds of pain it is, it will change into the forth kind of blood stasis shoulder pain. If the pain results from injury, the pain may combine with tenderness, swollen distend. Both of them have symptoms of frozen shoulder. The treatment should be to use acupuncture, cupping,TuiNa and Chinese herbs to remove blood stasis, stimulate blood circulation and stop pain.