Painful shoulder often occurs as a symptom due to sprain or strain of the soft tissues surrounding the shoulder joint, which may cause perifocal inflammation of the shoulder joint, supraspinatus tendinitis, infra-acromial bursitis, tendosynovitis of m. biceps brachii longus, etc.
Perifocal inflammation of the shoulder joint: This is due to chronic degeneration and inflammation of the bursa and the surrounding soft tissues of the shoulder joint. It may have started with a slight sprain or local chilling, or occur spontaneously. The pain may cover a large area and radiate to the neck and arm, and is accompanied with diffuse local tenderness. Pain that intensifies during quiescence is a marked feature, and there is limited movement when raising, abducting or stretching the arm posteriorly. Another notable feature of this condition is that pain is the main early complaint, while in the late stage the chief trouble is functional disturbance.
Supraspinatus tendinitis: This condition is a chronic inflammatory or degenerative change of the tendon often seen in manual laborers or athletes above middle age. Pain usually occurs on the lateral aspect of the shoulder, and there is tenderness at the tendon attachment of the supraspinatus to the greater tubercle of the humerus.
Infra-acromial bursitis: Chief symptom is tenderness on the lateral aspect of the shoulder. Pain and functional disturbance occurs when the upper arm is turned anteriorly, posteriorly, or horizontally.
Tendosynovitis of m. biceps brachii longus: Chief symptoms are pain, swelling and tenderness on pressure in the region of the m. biceps brachii longus anterior to the shoulder. Flexing of the elbow with voluntary contraction of m. biceps brachii causes intense pain. Pronounced pain is encountered when arm is abducted, raised or stretched posteriorly.
Tender points (ashi points)
Mainly used for perifocal inflammation of the shoulder joint and supraspinatus tendinitis.
In perifocal inflammation of the shoulder joint:
5 cc. of 10% glucose is injected into tender points, once every other day, 10 treatments to a course.
Treat the most sensitive point, if the tender point is broad. Select 2 - 3 points with the most pronounced tenderness.
In Supraspinatus tendinitis:
10 - 20 cc. of 1% procaine is slowly injected into the most tender area.
Source: The Treament of 100 Common Diseases by New Acupuncture, Medicine and Health Publishing Company