| Acupuncture is a precious Chinese culture heritage which derived from thousand years ago. Its unique in curing chronic pain made acupuncture nowadays are worldwide famous. Frozen shoulder as the third main causes in chronic pain diseases, is characterised by chronic pain and limited range of movement which made patients to suffer in doing their daily life activity. From western ideas, management for frozen shoulder including surgery manipulation to release adhesions beside of corticosteroid injection. These treatments are high cost and invasive to patients condition, not mentioned the side effect and risks which sometimes caused a great loss to patients.Objective: To practice acupuncture skills and massage combined with other noninvasive treatments as compherensive management in treating Frozen Shoulder disease.Methods: This paper contained of two case reports of patients diagnosed as frozen shoulder according to history, physical examination and radiologic findings. The first patient was treated with electroacupuncture , the second patient was treated with electroacupuncture and moxibustion acupuncture. They received a comprehensive treatments together with Chinese Massage (tuina),physical exercises and health education.Tools : 1. disposable filiform needles (Hwato product), length 50 mm , diameter 0.30 mm (for electroacupuncture) and diameter 0.35 mm (for moxibustion acupuncture); 2. electro-acupuncture device (Hwato SDZ-II); 3. TDP. 4. Moxa cones each length 2cm. Acupoints selected : 1. Main acupoints : Jianyu (LI 15) , Jianliao (TE 14) , Jianqian (EX-UE.), Quchi ( LI 11), Ashi points, for pain involving the back : Quyuan (SI 13) and Tianzong (SI 11) are added, for pain involving the upper arm : Binao ( LI 14) are added, for the pain in the anterior of the shoulder : Hegu (LI 4 ) and Lieque ( LU 7) are added.Performance : A. Electroacupuncture: 1. patients in sitting or prone position, 2. sterilized skin in area which needle will be inserted, 3. select acupoints based on patient complain and condition, 4. after the needle inserted, manipulating the needle with lifting thrusting manipulation until the arrival of qi (Deqi, needling sensation) achieved, 5. After insertion of the needle and arrival of qi, connect the needle to electric stimulator (choose 2-3 pairs of acupoints), Use irregular wave as wave form, than adjust the output current from small to large until the patient feel comfortable and can tolerate it. Keep the electric stimulation for 30 minutes. For additional can use heat lamp (TDP), put around affected shoulder area for 30 minutes, 6. after the times up, withdraw the needle. The treatment was given everyday for 10 treatments as one course. B. Moxibustion acupuncture : The step above are the same, but after insertion of needles and arrival of qi , pair of needles handle (selected acupoints such as Tianzhong (SI 11), Quyuan ( SI 13) , Jianliao ( TE 14 ) , Jianyu LI 15), Jianqian (EX-UE) and ashi points ) were wrapped with moxa cone to be burned. The needle is withdrawn after the moxa completely burns out and the ash is cleared. This treatment was given every other day for 5 sessions as one course.Patient 1 was treated with 1 course of electroacupuncture, patient 2 was treated first with 1 course electroacupuncture, after that with 1 course of moxibustion acupuncture.Results: Patient 1 achieved good therapeutic effect,pain diminished and affected shoulder's range of movement show good improvement. Patient 2 after received 1 course of electroacupuncture show a little improvement, but after received 1 course of moxibustion acupuncture,her pain disappear and her a affected shoulder's range of movement show good improvement.Conclusion: Electroacupuncture itself is useful to treat frozen shoulder disease. It can also combined together with moxibustion acupuncture to achieve maximal therapeutic effect of acupuncture treatments. Acupuncture as a compherensive treatment together with tuina ,physical exercises and health education, is a breakthrough in medical world which giving patients an alternative way to experience a complete,acceptable treatment which is lowcost and no side effect. |
