Connective tissue forms a “capsule” around the bones, ligaments, and tendons of the shoulder. If this capsule thickens or tightens, frozen shoulder can occur. The inflammation associated with frozen shoulder causes severe pain and restricted range of motion. Most of the time, there isn’t a cause of frozen shoulder, but it has been noticed that people with cervical spine (neck) injuries, diabetes, those who have had shoulder or open heart surgery, and hyperthyroidism are at an increased risk for frozen shoulder. The symptoms of frozen shoulder are ranged by stage:
- Stage One (painful stage): pain with movement, decreased range of motion
- Stage Two (frozen stage): less pain but more stiffness, further decrease in range of motion
- Stage Three (thawing stage): improved range of motion
Trigger points in the subscapularis can be released by inserting acupuncture needles directly into the muscle. While extremely effective at eliminating shoulder pain, having these trigger points needled can be uncomfortable due to the location of the subscapularis. To access the muscle, the acupuncturist needs to palpate somewhat forcefully inside the underarm. Another acupuncture technique for addressing pain from trigger points includes needling away from the actual pain site, choosing points along the acupuncture meridians that transverse the painful part of the body. For example, the small intestine meridian runs directly along the signature pain-referral pattern for subscapularis trigger points. An acupuncturist might choose to needle an acupuncture point on the small intestine meridian that’s farther down the body.