Shoulder Pain/Shoulder Impingement Syndrome (SIS)-
A Chinese Medicine Perspective
What is Shoulder Pain/Shoulder Impingement Syndrome (SIS)?
Shoulder pain is a common presenting complaint and affects approximately one-third of people at some point in their lives.
Such pain may lead to the impairment of shoulder joint function and to severe reduction in quality of life. Shoulder impingement syndrome (SIS), which is defined as the compression of the rotator cuff and the subacromial bursa, is considered to be one of the most common causes of shoulder pain. The typical sign of SIS is pain localised to the anterolateral acromial area, which may also radiate to the lateral mid-humerus .
There are three joints in the shoulder: the scapulo-humeral joint, the acromio-clavicular joint and the sterno-clavicular joint, the first two being the most important ones in shoulder pain . In addition there are four major muscles involved in the movements of the shoulder, they are the suprasinatus, subscapularis, terese minor and infraspinatus. There are also other minor muscles that work in conjunction with the four major muscles.
How Does Traditional Chinese Medicine (TCM) view Shoulder Pain
From a Chinese medicine perspective, pain in the shoulder may be due to either external causes or internal ones (organ pathologies) .
External causes include:
1. Invasion of External Cold
Invasion of the shoulder channels by external Cold is one of the most common causal factors. Cold contracts muscles, ligaments and/or tendons and therefore causes pain and stiffness in the joint and surrounding tissues. Typically, the pain would be aggravated by exposure to cold or when the weather is cold and damp. The local invasion of Cold leads to stagnation of Qi (the body’s own bio-electricity) in the shoulder channels (Sanjiao, Large Intestine and/or Small Intestine) and if the Cold is not expelled, the stagnation can become chronic. This will cause pain and also predispose the channels to further invasion of Cold, thus starting a vicious circle.
2. Excessive work or exercise
The constant repetition of a movement (repetitive strain) involving the shoulder joint, either through a particular sport or through work, will, over the years, lead to local stagnation of Qi in the shoulder.
Minor accidents cause local stagnation of Qi, while serious ones may cause stagnation of Blood and Qi. Very often, old injuries from accidents predispose the shoulder joint (or any joint) to invasion of Cold years later.
1. Gall Bladder problem (possibly due to inflamed gall bladder)
In a small number of cases, a problem in the Gall Bladder (such as Damp Heat) can affect the Small Intestine and Gall Bladder channels in the shoulder and cause referred pain in the shoulder joint.
2. Large Intestine problem
In an equally small number of cases, a shoulder pain along the Large Intestine channel can be the external manifestation of an organ problem.
Depending on the cause, the pain may differ. Injury from Cold will cause aching and dull pain, which may be relieved temporarily by application of heat. Similarly, stagnation of Qi tends to cause dull pain, while stagnation of blood causes sharp stabbing pain. Rubbing the painful area or applying heat, may relieve the pain temporarily.
Several studies have shown acupuncture to be a safe and effective treatment for shoulder pain [3,4,5].
At Kurrajong Natural Medicine Centre our highly qualified and experienced team of practitioners are happy to develop a personalised treatment programme with you. Simply call (02)4573 0784
1. Dong, W., Goost, H., Lin, X. B., Burger, C., Paul, C., Wang, Z. L., Zhang, T. Y., Jiang, Z. C., Welle, K., & Kabir, K. (2015). Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis. Medicine, 94(10), e510. https://doi.org/10.1097/MD.0000000000000510
2. Marciocia, G. (1994) The Practice of Chinese Medicine: The Treatment of Disease with Acupuncture and Chinese Herbs, Edinburgh: Elsevier Churchill Livingstone.
3. Shi, G. X., Liu, B. Z., Wang, J., Fu, Q. N., Sun, S. F., Liang, R. L., Li, J., Tu, J. F., Tan, C., & Liu, C. Z. (2018). Motion style acupuncture therapy for shoulder pain: a randomized controlled trial. Journal of pain research, 11, 2039–2050. https://doi.org/10.2147/JPR.S161951
4. Yan, C. Q., Huo, J. W., Wang, X., Zhou, P., Zhang, Y. N., Li, J. L., Kim, M., Shao, J. K., Hu, S. Q., Wang, L. Q., & Liu, C. Z. (2020). Different Degree Centrality Changes in the Brain after Acupuncture on Contralateral or Ipsilateral Acupoint in Patients with Chronic Shoulder Pain: A Resting-State fMRI Study. Neural plasticity, 2020, 5701042. https://doi.org/10.1155/2020/5701042
5. Lee, J. A., Park, S. W., Hwang, P. W., Lim, S. M., Kook, S., Choi, K. I., & Kang, K. S. (2012). Acupuncture for shoulder pain after stroke: a systematic review. Journal of alternative and complementary medicine (New York, N.Y.), 18(9), 818–823. https://doi.org/10.1089/acm.2011.0457