2023 Journal of Evidence-Based Medicine

Guidelines have been developed for treating frozen shoulder using traditional Chinese medicine, with multiple therapies such as acupuncture and exercise recommended.

The development of evidence-based guidelines followed internationally recognized standards and used the Grading of Recommendations Assessment, Development and Evaluation approach to determine the certainty of evidence and the strength of recommendations. A multidisciplinary group formed the development panel, who took into account benefits, harms, availability of resources, accessibility, and other factors. Nine clinical queries were defined after conducting a systematic literature review and a face-to-face meeting.

The guideline panel reached a consensus on twelve recommendations which included treatments like manual therapy, acupuncture, needle knife, Cheezheng Xiaotong plaster, Gutong plaster, exercise therapy and an integrated approach of traditional Chinese medicine and Western medicine. Their strength ranged from weakly recommended to consensus based. This new guideline targets clinicians and health administrators.

Traditional Chinese medicine for frozen shoulder: An evidence‐based guideline Qin X, Sun K, Ao Y, Liu J, Wang M, Deng Q, Zhong W, liu J, Sun S, Liu X, Shi B, Guan X, Du S, Zou J, Wu C, Chen F, Fang Y, Nie X, Mo W, Guo J, Zhang Y, Dong Y, Wei X, Zhu L

2022 Frontiers in Medicine

Electroacupuncture may be more effective than manual acupuncture for managing frozen shoulder, with larger effect sizes in terms of pain, function, and response rate.

This review included thirteen studies involving 936 patients. The EA group exhibited improvements in FS pain, function, and response rates over the manual acupuncture (MA) group. As an adjunct treatment, EA improved FS pain compared to the control treatments. No adverse effects were reported.

EA was found to be an efficacious method for treating FS in this review. The meta-analysis showed that EA led to a greater reduction of FS pain than MA did, although with a very low certainty of evidence. In comparison to MA, EA led to a superior degree of functional improvement in FS patients, with a very low certainty of evidence. In comparison to MA, EA enhanced the response rate of FS, again with a low certainty of evidence. Compared with WM used in isolation, EA plus WM reduced FS pain with a low certainty of evidence.

Electroacupuncture for the treatment of frozen shoulder: A systematic review and meta-analysis Heo JW, Jo JH, Lee JJ, Kang H, Choi TY, Lee MS, Kim JI

2021 American Journal of Translational Research

Massage combined with acupuncture can better improve the range of motion of joints and daily living ability of patients with frozen shoulder complicated with cervical spondylosis.

A total of 164 patients with frozen shoulder treated in our hospital from June 2016 to April 2019 were recruited and divided into a control group and an observation group. There were 100 cases in the observation group, all of whom were treated with massage combined with acupuncture. Another 64 cases were enrolled in the control group, all of whom were treated with acupuncture alone. The recovery of myodynamia, rating scale of the American Shoulder and Elbow Surgeons (ASES), score of American Spinal Injury Association (ASIA), ROM score, vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1), complication rate, total effective rate, and patient satisfaction were assessed.

After treatment, patients in the observation group had better recovery of myodynamia than the control group. They also had lower VAS scores, higher life function score and total ASES scores, higher ASIA scores, higher ROM scores, lower VCAM-1 and ICAM-1 expression, lower complication rate, higher total effective rate, and higher patient satisfaction.

Effects of massage and acupuncture on the range of motion and daily living ability of patients with frozen shoulder complicated with cervical spondylosis Liu M, Liu Y, Peng C, Wang H, Xu Y, Jiao S, Ding Y

2020 Evidence-Based Complementary and Alternative Medicine

Acupuncture could be safe and effective for pain reduction, restoring shoulder function, and restoring flexion range of motion for frozen shoulder patients in the short term and midterm.

In this systematic review and a meta-analysis, acupuncture had shown to be a safe treatment with a significant effect in regard to reducing pain, improving shoulder function, and flexion ROM in the short term and midterm. However, due to the small number of included studies and methodological limitations in these studies, more large-scale high-quality RCTs are warranted in order to give a robust conclusion. Future studies should compare acupuncture to other treatments and sham acupuncture. Additionally, longer follow-up time is needed for investigating the effect of acupuncture in the mid- and long term, and the duration of future FS studies follow-up should be increased to one year.

The Effectiveness of Acupuncture in the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis Ben-Arie E, Kao PY, Lee YC, Ho WC, Chou LW, Liu HP

2017 Physiotherapy

Acupuncture combined with physiotherapy or exercise was found to be more effective for frozen shoulder than physiotherapy or exercise alone in the short and long term.

Shoulder pain is a leading musculoskeletal pain complaint, and is responsible for high morbidity with marked impact on quality of life. Acupuncture is a modality commonly employed in the treatment of shoulder conditions; however, past systematic reviews investigating its effectiveness have been inconclusive, noting a paucity of good quality research. A new body of research has since been published, and is included within this review. The objective of this systematic review was therefore to investigate the current evidence base for the effectiveness of acupuncture in the treatment of shoulder pain.

Effectiveness of acupuncture in the treatment of shoulder pain: a systematic review of published randomised clinical trials A. Rubio M. Mansfield J. Lewis

2016 Materia Socio Medica

Acupuncture may enhance shoulder movement and relieve pain more effectively than standard treatment in patients suffering from adhesive capsulitis, also known as a frozen shoulder.

In the methodology utilized, a controlled clinical trial was conducted on 40 patients diagnosed with frozen shoulder who were referred to a health clinic. Diagnostic measures included assessing variables such as joint pain, range of motion, and quality of life. Data was collected through pre-determined questionnaires at baseline, one and a half months later (end of the session), and then three months after the examination.

In terms of results, a comparison of the intervention group treated with acupuncture and the control group revealed significant improvements in shoulder movement, particularly flexion and adduction. Additionally, the Visual Analog Scale (VAS) index, showing the level of pain, indicated greater improvements in the acupuncture group three months after the treatment. Overall, the acupuncture group showed higher enhancement in shoulder motion, suggesting acupuncture as a potent treatment method for frozen shoulder.

Investigation of the Effectiveness of Acupuncture in the Treatment of Frozen Shoulder Asheghan M, Aghda A, Hashemi E, Hollisaz M