Shoulder Painaccording to TCM

What is Shoulder Pain?

Shoulder pain refers to discomfort or pain in the shoulder region, which includes the muscles, tendons, and ligaments surrounding the shoulder joint. This pain can result from a variety of causes, such as injuries, overuse, or underlying medical conditions like arthritis or bursitis. Symptoms can range from a dull ache to sharp, debilitating pain, often affecting the range of motion and functionality of the shoulder.

How Does TCM View Shoulder Pain?

In Traditional Chinese Medicine (TCM), shoulder pain is viewed as a manifestation of imbalances or blockages within the body's energy channels, or meridians. Unlike Western medicine, which may focus on structural or inflammatory causes, TCM considers patterns of disharmony such as Qi and Blood Stagnation, Wind-Damp obstruction, or Deficiencies in the Kidneys or Liver. Identifying the specific pattern is crucial for effective treatment, as each pattern requires a different therapeutic approach to restore balance and alleviate pain.

Root Causes of Shoulder Pain in TCM

In TCM, shoulder pain can arise from various patterns of disharmony. One common cause is Painful Obstruction Syndrome, characterized by symptoms like shoulder pain, stiffness, and limited mobility. This can be due to Wind, Cold, or Dampness invading the meridians and obstructing the flow of Qi and Blood. Another pattern is Qi and Blood Stagnation, where the circulation of vital energy and blood is impeded, leading to pain and discomfort.

Explore below more details about what might cause Shoulder pain according to TCM.

TCM Herbal Formulas for Shoulder Pain

TCM offers a range of formulas and herbs tailored to address the underlying patterns causing shoulder pain. For Painful Obstruction Syndrome, Wu Tou Tang is often recommended. This formula, which includes Prepared Sichuan aconite as a key herb, works to warm the meridians and disperse Cold, alleviating pain and stiffness. It is essential to select the appropriate formula based on the individual's specific pattern of disharmony to achieve effective results.

Explore below some TCM herbal formulas used to address shoulder pain, organized by cause and by formula type.

Acupoints for Shoulder Pain

Acupuncture is a fundamental treatment in TCM for alleviating shoulder pain. Specific acupoints are targeted to enhance the flow of Qi and Blood, remove obstructions, and reduce pain. In the Small Intestine Channel, points like Bingfeng (SI-12) and Jianzhen (SI-9) are used to open the channels and expel Wind. In the Large Intestine Channel, points such as Jianyu (LI-15) and Jugu (LI-16) help remove obstructions and resolve phlegm, providing relief from shoulder pain. These acupoints, among others, are strategically selected to address the root causes and symptoms of shoulder pain in a holistic manner.

Explore below some acupoints used to address shoulder pain, organized by meridian.

Shaoze SI-1

On the ulnar side of the little finger, about 0.1 cun posterior to the corner of the nail.

Houxi SI-3

Proximal to the head of the 5th metacarpal bone on the ulnar side, in the depression at the junction of the red and white skin.

Wangu SI-4

On the ulnar side of the palm, in the depression between the base of the 5th metacarpal bone and the carpal bone.

Yanglao SI-6

Dorsal to the head of the ulna. When the palm faces the chest, Yanglao SI-6 is in the bony depression on the radial side of the styloid process of the ulna.

Xiaohai SI-8

Between the olecranon of the ulna and the medial epicondyle of the humerus.

Jianzhen SI-9

Posterior and inferior to the shoulder joint. When the arm is adducted, Jianzhen SI-9 is 1 cun above the posterior end of the axillary fold. Naoshu SI-10 is located directly above Jianzhen SI-9.

Naoshu SI-10

When the arm is adducted, Naoshu SI-10 is directly above JianZhen SI-9, in the depression inferior and lateral to the scapular spine.

Tianzong SI-11

In the intrascapular fossa, at the junction of the upper and middle third of the distance between the lower border of the scapular spine and the inferior angle of the scapula.

Bingfeng SI-12

In the center of the suprascapular fossa, directly above Tianzong SI-11. When the arm is lifted, the point is at the site of the depression.

Quyuan SI-13

On the medial extremity of the suprascapular fossa.

Jianwaishu SI-14

3 cun lateral to the lower border of the spinous process of the 1st thoracic verrtebra (T1), on the vertical line drawn from the levator scapulae muscle.

Jianzhongshu SI-15

2 cun lateral to the lower border of the spinous process of the 7th cervical vertebra (C7).

Shangyang LI-1

On the radial side of the index finger, about 0.1 cun posterior to the nail corner.

Erjian LI-2

On the radial side of the index finger, distal to the metacarpophalangeal joint, at the junction of the white and red skin.

Wenliu LI-7

When a fist is made, with the ulnar side downward and elbow flexed, the point is 5 cun above Yangxi LI-5 at the wrist crease, 1 cun distal to the midpoint of the line joining Yangxi LI-5 and Quchi LI-11.

Shanglian LI-9

When a fist is made, with the ulnar side downward and elbow flexed, the point is 3 cun distal to Quchi LI-11 of the line joining Yangxi LI-5 and Quchi LI-11.

Shousanli LI-10

When a fist is made, with the ulnar side downward and elbow flexed, the point is 2 cun distal to Quchi LI-11 of the line joining Yangxi LI-5 and Quchi LI-11.

Quchi LI-11

When the elbow is flexed, Quchi LI-11 is in the depression at the lateral end of the cubital crease, midway between Chize LU-5 and the lateral epicondyle of the humerus.

Shouwuli LI-13

Superior to the lateral epicondyle of the humerus, 3 cun above Quchi LI-11, on the line connecting Quchi LI-11 and Jianyu LI-15.

Binao LI-14

On the radial side of the humerus, superior to the lower end of deltoid muscle, on the line connecting Quchi LI-11 and Jianyu LI-15, 7 cun proximal to Quchi LI-11.

Jianyu LI-15

Jianyu LI-15 is located antero-inferior to the acromion, between the clavicular and acromial portions of the deltoid muscle.

Jugu LI-16

In the upper aspect of the shoulder, in the depression between the acromio-clavicular joint and the scapular spine.

Yangchi TB-4

At the junction of the ulna carpal bones of the wrist dorsum, in the depression lateral to the tendon of extensor digitorum and extensor digiti minimi muscle.

Waiguan TB-5

2 cun above Yangchi TB-4 at the dorsal wrist joint space, between the radius and ulna.

Zhigou TB-6

3 cun above Yangchi ST-4 at the dorsal wrist joint space, between the radius and ulna.

Huizong ST-7

3 cun proximal to the dorsal wrist joint space and 0.5 cun ulnar to the forearm center.

Sanyangluo TB-8

Between the radius and the ulna, 4 cun above Yangchi TB-4, which is on the dorsal wrist joint space.

Qinglengyuan TB-11

1 cun above Tianjing TB-10 or 2 cun superior to the olecranon.

Xiaoluo TB-12

On the line joining the olecranon and Jianliao TB-14, midway between Qinglengyuan TB-11 and Naohui TB-13, 5 cun proximal to the olecranon. It is just on the lower end of bulge of the lateral head of triceps brachii when the forearm is in pronation.

Naohui TB-13

On the line joining Jianliao TB-14 and the olecranon, 3 cun below Jianliao TB-14 which is at the lateral extremity of the acromion. Naohui TB-13 is on the posterior border of deltoid muscle.

Jianliao TB-14

Posterior and inferior to the acromion, in the depression about 1 cun posterior to Jianyu LI-15.

Tianliao TB-15

Midway between Jianjing GB-21 and Quyuan SI-13, on top of the superior angle of the scapula.

Tianzhu BL-10

1.3 cun lateral to Yamen DU-15 on the posterior midline, 0.5 cun above the posterior hairline, on the lateral side of trapezius muscle.

Ganshu BL-18

1.5 cun lateral to the lower border of the spinous process of the 9th thoracic vertebra (T9).

Pohu BL-42

3 cun (about 4 finger-breadths) lateral to the lower border of the spinous process of the 3rd thoracic vertebra (T3).

Yixi BL-45

3 cun (about 4 finger-breadths) lateral to the lower border of the spinous process of the 6th thoracic vertebra (T6).

Kunlun BL-60

In the depression between the tip of the lateral malleolus and the Achilles tendon.

Fubai GB-10

Posterior and superior to the mastoid process, at the junction of the upper third and the two lower thirds of the curved line connecting Tianchong GB-9 and Wangu GB-12.

Jianjing GB-21

Midway between Dazhui DU-14 and the lateral extremity of the acromion, at the highest point of the shoulder.

Zhejin GB-23

1 cun anterior to Yuanye GB-22, approximately level with the nipple.

Shuitu ST-10

On the anterior border of sternocleidomastoid muscle, in the middle between Renying ST-9 and Qishe ST-11.

Quepen ST-12

About 4 cun lateral to the anterior midline, in the supraclavicular fossa, superior to the midpoint of the clavicle.

Tiaokou ST-38

8 cun below Dubi ST-35, midway between Dubi ST-35 and Jiexi ST-41, one middle finger-width from the anterior crest of the tibia.

Yunmen LU-2

On the antero-lateral aspect of the chest, below the lateral extremity of the clavicle, about 6 cun lateral to the anterior midline in the centre of the deltopectoral triangle.

Chize LU-5

On the cubital crease, on the redial aspect of the biceps tendon. It can be easily identified when the elbow is slightly flexed.

Jianqian EX-UE

On the midpoint of a line connecting the end of anterior axillary fold and Jianyu LI-15.

Qingling HE-2

3 cun above the medial end of the transverse cubital crease, in the depression medial to the biceps brachii muscle.

Tianquan P-2

2 cun below the end of the anterior axillary fold, between the two heads of biceps brachii muscle.