Shoulder Surgery and Acupuncture
Quite recently, I’ve seen cases where patients came to me with shoulder issues, sometimes following surgery related to either the hand or shoulder. I thought now it would be a good opportunity to relate my findings.
The Nature of Upper Extremity Complications
Though I shy away from axiomatic pronouncements, it is fair to say that essentially all extremity problems for those under 65, that is all those involving the rotator cuff, bursitis, and related, involve the neck. Pain experienced at the shoulder, elbow, and wrist is pain referred not the pain source.
“Referred pain” means that sensation at pain’s site is not the origins of the pain itself, rather it is a sensation that radiates farther up along the nerve pathway. Central to treating this pain is locating whence the pain originates along the pathway.
These problems can originate either from pathways that stream along the front (anterior) or back (posterior) aspects of the neck. Below is an image charting the anterior aspects of the nerve branches.
Upper Limb Nerve Pathways Treated by Acupuncture
Problems Causing Pinched Nerves
There are a few factors that can impair the flow of nerve impulses in the upper extremities, these are posture, injury, sugar imbalance, and nervous system hyperactivity. These dynamics can interrelate but aside from acupuncture require different types of interventions. For example, posture requires ergonomic and exercise intervention; injury requires herbs for repair; sugar related impingement requires dietary assessment; and nervous system hyperactivity benefits from certain breathing exercises and meditation. The point is that a problem affecting skillions of people can arise as a result of different problems depending on the specifics of the individual. These variables is what places diagnosis as the cornerstone of treatment.
“My CAT Scan and MRI Show I Need Surgery“
All data must be interpreted. If certain procedures show that surgical suggestions coincide with the site of pain, it is reasonable to conclude that that site is where a procedure should be conducted. At the same time, all data must be interpreted and a more informed question concerns whether the technological readings reflect a referred phenomenon. Along the lines of that which was stated earlier, the site of pain is rarely the site whence pain originates. Could technological readings that coincide with the site of pain be reflecting “referred” metabolic processes? Additionally, surgeons are paid on a per treatment basis, could their interpretations of the technological data be informed by considerations beyond what the data suggest? Here’s a discussion that addresses that very question.
Acupuncture Cases: Upper Limb Issues
60+yo female, Post-Op Hand
“Daikon” came to me for help with intestinal issues, particularly loose stools and Alzheimer’s A holistic approach means that all problems must be taken into consideration. She also has a should problem, which she began feeling after a surgical procedure last winter for a broken wrist. Post-surgery treatment involving a physical therapist proved significantly beneficial to the extent of restoring use of hand but hand-strength and shoulder mobility proved challenged more than 8 monts post surgery.
Solution: Posterior treatments of the neck and scapula provided better than 60% improvement in range of motion after four treatments. Anterior treatment of the neck have helped increase strength of hand by better than 65% after two treatment. Jury is out on the mobility of the shoulder when reaching behind her back. In more than four sessions she had been able to perform the movement with great ease but the results wear off after two or three days. In one session we used EFT to equally positive yet waning results Anytime a supposed physical constraint responds to EFT, then there is a significant emotional component, especially if the problem recurs.
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28 yo male, Post-op Leg
“Roast Beef” came to me upon referral for “carpal tunnel.” A close associate in the health field had suggested that he pursue nonsurgical approaches to his problem. Roast Beef is physically active but has been constrained by his wrist pain. He’s been wearing a brace. After his first treatment he felt no pain for 12 days, while wearing a brace. His schedule has been every 14 days. Each session has involved facets of the posterior aspect of his condition: trigger points, blood circulation, and integration between the upper and lower aspects of the body. After the last session, he noted that he had had surgery on his right calf, which had been without pain but numb post-surgery three years prior. He felt sensation in his calf for the first time since the procedure and his wrist recovery continues to be well on pace after only three sessions.
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50+ yo male, post-op shoulder
“Kale” came to me after much encouragement from his Tamil mother-in-law, a patient of mine. He had a regular acupuncturist, but decided to give in for family’s sake. The matter was wrist and elbow pain, particularly noticeable upon the shaking of hands. Aside from his symptoms, I noted some pre-symptomatic heart issues which happened to run in the family. This was addressed summarily, which gained his confidence in my competence. He noted that he had had a surgical procedure for his shoulder five year prior, and that it might relate to his problem. In fact, the site of pain at thoracic 8 was still sensitive and proved a significant trigger point for strengthening his grip and reducing pain.
Amidst treating the hand/elbow, which is about 90% improved, a lingering upper respiratory infection has been addressed. With regard to the arm strength, I estimate about two more sessions will be necessary. Some factors regarding circulatory strength, previously shown in the heart, could be involved. Our talks on 80s corny rock music notwithstanding, he’s been duly impressed.
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40+ yo male, post-op shoulder, guitarist
“Cantaloupe” is a case just seen only once. He had a should procedure more than two years ago and experiences neck pain arising from an injury at around thoracic 10 more than two years ago. He had considered chiropractic services but was referred by a good friend who thought that I might be more helpful. He’s visiting Los Angeles from the Bay Area.
In contrast to the cases above, Cantaloupe complained of neck pain specifically, pain that radiated to the “pecks”, i.e., the anterior aspect of the body. We worked for better than an hour, whereupon he noted better than 80% improvement in all the areas of neck pain… to his astonishment. The jury is out on just how long the treatment effects have lasted but there is no doubt that he wasn’t just whistling Dixie as he shook my hand upon exist and said “I feel better.”
Conclusion
Acupuncture can be extremely helpful in resolving a number of upper limb issues. This includes post-op cases. Key to resolving shoulder issues with acupuncture is an understanding that shoulder pain is referred, which requires careful examination of the neck and related trigger points along the nerve pathway.