Volume 7, Number 2 | Summer 2012

Japanese Acupuncture - Current Research
Japanese Traditional Medicine Text (4) – OrthopedicDisorders A

Although both groups reported less shoulder discomfort
in the majority of cases, neither group reported
improved range of motion.

Daisuke Mine

Further, no difference in therapeutic result was seen

Physiotherapy Section,either with or without therapeutic encouragement1).

Central Rehabilitation Service,

Since the late 1990s, an increase in the number of

The University of Tokyo Hospitalsystematic reviews of acupuncture for shoulder pain
have appeared as systematic reviews, especially withA Shoulder Joint

an increase of RCT papers. A representative report by

1. Clinical Studies from Abroad

Green (2005) will be discussed here (Table 4).

Concerning the efficacy of Acupuncture treatment for

Subjects were included if they met the evaluation

Conditions of the Shoulder Joint, until recently there

criteria (older than 3 months of age, rheumatoid

havemostlyarthritis or radiating pain from the neck area,

concerning the alleviation the pain associated with

excluding fractures, etc.). The investigators analyzed

arthritis of the shoulder joint and injury of the rotator

results from 9 trials. Unfortunately, the small sample

been

many

reports

fromabroad,cuff. The earlier research from Moore (1976), was arandomized controlled trial treating chronic shoulder
pain, they divided subjects into 2 groups, traditional
Chinese acupuncture or a superficial placebo protocol,
and investigated the effects of patient encouragement
between the groups.
Table 4andwidevariation

ininterventions

andevaluation points diminished the clarity of the results.
In conclusion, acupuncture was found to be effective inthe short-term for shoulder pain and may be valid given
standardized

futureinterventions

appropriateevaluations.

includingRecommendations

fornecessary future studies are proposed 2).

Green et al. adopted a systematic review article

First Author / Yearof Publication
Moor ME
1976

Target(Subjects)
chronic
shoulder pain
42 cases

Berry H1980

shoulder - cuff
lesion60 cases

Lin ML
1994

frozen shoulder
150 cases

Yuan
1995
Kleinhenz
1999

periarthritis
98 casesrotator cuff
tendinitis
52 cases
painfulshoulder24 casesshoulder’smyofascial pain
44 caseschronic
shoulder pain
20 casesshoulder pain
35 casesRomoli M
2000
Ceccheerelli F2001
Dyson TA2001
Sun2001

size,Intervention

Conclusion*Traditional Chinese Medicine (with encouragement/without encouragement)*Sham Treatment (with encouragement/ withoutencouragement)*Acupuncture needles*Steroid injection + Placebo Medication injection*Steroid Injection + Oral Medication*Ultrasonic Waves*Placebo Ultrasonic Waves + Placebo Medication
Injection*Stellate ganglion block + supra-scapular nerve block*Electro-acupuncture*Electro-acupuncture + Nerve Block*Meridian Theory Based Acupoint Location*Acupoint Location based on Chinese Medical Etiology*Acupuncture (needles)*Sham Acupuncture

Both groups reported improvementin their level of discomfort
No significant difference between
groupsAll groups reported improvement
No significant difference between
groups*Acupuncture+ Mobilization*Mobilization*Auricular Acupuncture + Mobilization*Shallow Needling (2mm)*Deep Needling (Muscle layer)

No significant difference between
groups*Acupuncture*Trager psychophysical integration*Acupuncture + Exercise*Exercise

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Effectiveness of Electroacupuncture + Nerve Block
Effectiveness of Acupoint Location
based on Meridian TheoryEffectiveness of Acupuncture

Pain was inhibited in both groups
Deeper needling showedremarkable
Effective for/in both groups
No significant difference between
groups
Efficacy of Acupuncture combinedwith Exercise3Volume 7, Number 2 | Summer 2012

2. Prospectus and overview of Current Studies in Japan

greater increases in range of motion. Therefore theIn Japan, numerous reports are available on Shoulder

researchers suggested that, for best results, treatment

joint inflammation and Frozen shoulder. Katayama etshouldal., divided 12 subjects (thirteen shoulders) diagnosed

spontaneous pain and contracture occur5). There arewith shoulder joint arthritis into 2 groups based on

many such reports demonstrating the effectiveness of

their limited range of motion. The Japan Orthopedic

acupuncture for shoulder joint pain and limited range

Society of Shoulder Joint Disease Treatment andof motion. However, there are several confounding

Performance Criteria (JOA score) was used to evaluate

points that must be addressed, 1) most of the available

pain, function and range of motion. Most notably, thereports have been drawn from compilations of clinicalextremely limited range of motion group reportedly

reviews and clinical case study reports, there are noexperienced the greatest improvement in pain and bothother treatment methods reported in the literature. 2)groups demonstrated improved results for all criteria 3).

Because inflammation of the Shoulder Joint andThe treatment protocol involved treating acupuncture

Frozen shoulder are general terms that include a range

points and/or appropriate Trigger Points in the Deltoid,

ofBiceps and Supraspinatus muscles; retention time waspathophysiological description of these complaints

short with thrusting or embedded needles for longer

should be defined or systematized. 3) Although there isretention. Hori et al. reported on the observed changes

sufficient evidence pointing to the effectiveness of thein shoulder pain and range of motion in patientstreatment methods and evaluation techniques, thefollowing low frequency electro-acupuncture in 21

current conditions do not provide affirmative evidence

patients with Frozen Shoulder. Seventy-one percent ofthat acupuncture and moxibustion are effective. In

participants reported slight relief of their subjective

order to clear away these confounding factors,

symptoms, 29% of subjects with extreme pain also

appropriately designed research studies allowing forreported some relief 4). Also, Sakai et al. investigated 41

collaboration with medical institutions and medical

people with Shoulder joint inflammation. These

specialists

subjects were divided into an admissible contracture

acupuncturegroup (21) and the no contracture group (20),

Originally, acupuncture therapy was a treatment

respectively. Changes in pain scores and range ofsystem corresponding to each patient's individual

movement were re-evaluated following one month ofcomplaints, different patients with the same disease

weekly treatments. The purpose of this treatment was

should receive unique treatment, and further it is well

to reduce muscle tension and improve blood circulation

known that the skills of the individual practitioner

in the rotator cuff, long head of the biceps andgreatly influence treatment efficacy. However, in ansurrounding tendons. Depending on the presenting

attempt to improve the level of acupuncture anddysfunction, level of radiating pain and location ofmoxibustion treatment efficacy in the future, othermuscle tension, treatment might include needle

treatment methods should be compared and consideredretention and low frequency electro-acupuncture.

complementary and clarifying the effects of these

Results suggest that, without respect to effectivenesstherapies for shoulder arthritis should be a priority.

for contracture, comparing patients presenting withStandardized

spontaneous pain to those without spontaneous pain,

methods are required for specific disease stage andthose without spontaneous pain reported reduced pain

pathophysiology.

beinstigatedmore

specificaretreatments

evaluation

changes in range of motion, the research confirmed thatpatients without significant contracture enjoyed much

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

theconditions,urgentlyfollowing the treatments. In terms of effectiveness for4

duringneededandphasethebefore

precisetoevaluate

researchmethods.

criteriaandtreatment

Volume 7, Number 2 | Summer 2012

References1) Moor ME, Berk SN: Acupuncture for chronic
shoulder pain. An experimental study withattention to the role of placebo and hypnotic
susceptibility. Ann Intern Med 84(4): 381-384,
19762) Green S, Buchbinder R, Hetrick SE: Acupunctureforshoulder

pain.

CochraneDatabaseofSystematic Reviews 2005, Issue 23) Kenji Katayama, Tatsuo Katsumi, Tatsumi
Nakamura,etal.:

Effectofacupuncture

treatment for PERI-ARTHRITIS of the shoulder
joint. Eastern Medicine 12 (3): 1-11, 1996
4) NorikoHori,Hitoshi

Yamashita,

Hiroshi

Tsukayama, et al: Effects of acupuncture forfrozen shoulder ─ an integrated case study ─.
Japan Society of Acupuncture 46 (4): 340-344,
1996
5) Tomomi Sakai, Yasushi Mizude, KasuyaDaichi etal.: The effect of acupuncture treatment for PERIARTHRITIS of the shoulder joint. MedicalJournal of Day Temperature 60 (4): 200-208, 1997.

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