Abdominal acupuncture used to treat chronic shoulder and rib pain

Chronic Shoulder and Rib Pain

Gill was used to having pain in her left shoulder and neck, as it had been a constant part of her life for approximately eighteen months when she first came to see me. She almost cancelled her appointment on the day because she had developed such severe pain under her arm around the axillary fold that had moved across into her chest the night before. The pain during the night was uncontrollable and quite frightening to Gill as she had never experienced anything like it before. She consulted her doctor in the morning who felt that it was a muscle strain and ruled out a heart attack, to Gill’s relief! 

Gill’s shoulder and neck pain had been attributed to a lifetime of cleaning work and general wear and tear. She had no other health issues other than gum disease which was causing her gums to bleed in recent weeks, leaving one tooth in particular quite loose. The shoulder pain usually radiated around the anterior, lateral and posterior portion of the shoulder joint and often radiated towards LI 14 (Bi Nao) sometimes as far as her wrist. It also radiated up towards Du16 (Feng Fu) and GB 20 (Feng Chi) on the left hand side. It was a painful and scary shock for her when the previous night she had got such a serious pain under her arm in the anterior serratus muscle. 

I asked Gill to tune into where her pain was presently. It was still in the area’s described above. Although the under arm pain was considerably less than it had been the previous night it was still at a 7 on her pain scale while the shoulder joint pain at the front and back was at an 8 and the lateral aspect was less for her at a score of 5 out of 10. There was no pain radiating to the neck at this stage. I explained how the Abdominal Acupuncture would most likely give her immediate relief, although it should be noted that this can sometimes take a little time to become apparent in older persons with chronic conditions. At 68 years of age she did fall into this category. I asked her to once again focus on the areas of discomfort and to now give each a reference point score of 10 out of 10 which would act as a baseline indicator. I also asked her to move her arm in the ways that were most likely to aggravate her pain to give an idea of range of pain free motion. Putting on or removing her bra was the most painful for Gill, as she did this movement it was very obvious how much pain it caused.

I observed and palpated her abdomen and found an obvious little ahshi point at St 24 Shoulder (Huaroumen). I also located another node or ahshi point approximately 0.7cun lateral to Ren 9 on her left side which I was confident would relieve the pain around the ribs. I used "Heaven & Earth" Ren 12 (Zhongwan) and Ren 4 (Guanyuan) with Kid 17 (Shangqu) on the right followed by St 24 Shoulder (Huaroumen) Ab 1 (elbow) and Ab 2 (wrist) on the left. I fixed all these needles to the correct depth and then checked how the pain was in the shoulder. The pain was much reduced at a score of 3 : 10 in the shoulder joint. The rib / under arm pain was still at 8:10 so I also needled the ahshi point 0.7 cun lateral to Ren 9 (Shuifen) on the left. The depth of this needle was approximately 0.4cun which brought her pain level down to a reference point score of 1 or 2 out of 10. She was very relieved that this disturbing pain was almost gone as she was still concerned about her heart even though her doctor had assured her there was no issue. I again checked what the pain level was at the shoulder joint and she still had some discomfort upon movement, although her range of motion had improved by around 20%. I decided to check the affect of St 24 Shoulder (Huaroumen) and Kid 17 (Shangqu) before adding any more needles. I adjusted the depth of St 24 first leaving it at a depth of around 0.6 cun which was at the deeper level of the Heaven layer. This made a huge difference and reduced the pain in the joint to a minimal reference score of 1 out of 10. 

Gill’s Second abdominal treatment - Gums

 It was six weeks since I had seen Gill and she was delighted to be back again. She started by telling me how incredible she had felt after the first session. She said that she had been almost completely pain free for four of the six weeks and that although the pain was starting to rear its ugly head again it was still only a fraction of what it had been when she had her first treatment. She had not had anymore pain under her arm in the anterior Serratus muscle and she was sleeping better as a result. Fastening and undoing her bra was once again difficult after the initial four weeks reprieve but she had not had any referred pain into her wrist. Her neck was noticeably better also only bothering her after over doing her cleaning work!

I started with a simple and similar treatment to Gill’s first session. I used "Heaven & Earth" Ren 12 (Zhongwan) and Ren 4 (Guanyuan) with Kid 17 (Shangqu) on the affected left side St 24 Shoulder (Huaroumen). Because she had quite a lot of pain around LI 14 I included Ab 1 (elbow), this was not enough to correct the focal point of the pain so I used a point about 1/3 the way between these two points. After checking the pain reference point score, Gill acknowledged that it was now down to 2 out of 10. It was at this stage that Gill mentioned she had been to the dentist because her gums had been bleeding in the last few months. The dentist, advised her to change toothpaste and to floss (not the dance!) regularly. I told her I would do something to help and I adjusted the depth of Ren 12 (Zhongwan) so that it was very superficial to treat the gums, I then adjusted the depth of Ab 1 (elbow) so that it was deep and in the Earth layer to nourish Spleen Qi. I also included Kid 13 (Qixue) in order to send Yin Qi to here gums and to nourish her Kidney essence. She was now out of pain and happy to relax and hope that there was a cure for her gum problem!

Gill’s Third abdominal treatment

On her next visit Gill told me that she had been pain free for over three weeks until the last two days. After taking down the Christmas tree and decorations the pain had returned on her left shoulder into her upper arm and down to her wrist. It was still only a fraction of the pain she had endured for years though. I had her do a test to aggravate the pain by mimicking putting on her Bra, which was painful, especially at LI 14 (Bi Nao). Her Stomach pulse felt weak, and she told me that food had been going through her due to her increased Christmas chocolate consumption.

Fig 1. Illustration of Gill's third abdominal treatment.

Her lung pulse was pounding and a little rapid, and she disclosed that she had a cough after smoking more over the holiday celebrations! Her gums had been better overall with less bleeding and she was now using a softer toothbrush and flossing regularly.

The prescription used this time was "Heaven & Earth" Ren 12 (Zhongwan) and Ren 4 (Guanyuan) with Kid 17 (Shangqu) on the right followed by St 24 Shoulder (Huaroumen) Ab 1 (elbow) and Ab 2 (wrist) on the left. I also added an ahshi point 1/3 the way between St 24 Shoulder and Ab 1 (elbow) to address the pain at LI 14 (Bi Nao). To correct her digestion and help with her cough I added "Harmonising the Middle Jiao" St 25 (Tianshu) & Sp 15 (Daheng). With all the needles in situ I checked the change in her pain tweaked the ahshi and St 24 Shoulder points until she was completely pain free with improved mobility. Towards the end of the treatment I adjusted the Ren 12 (Zhongwan) needle by withdrawing it to a more superficial level, I also went deeper with Ab 1 bringing it to the earth level to work on the Spleen Qi. Both of these adjustments would improve the health of Gill’s gums.

Conclusion

Gill had one more treatment and she was delighted to inform me that although she had discomfort down her arm for two days after the last session she had been pain free since, with no problem putting on or taking off her bra. She was also happy that her formerly loose tooth was now firmly rooted once again and that her gums had not bled since the second treatment.

In the four times I have seen Gill her shoulder has completely healed, she has no trouble with the bleeding gums and she overcame the huge shock and fear that the anterior Serratus muscle pain. She was told by her doctor and dentist that these problems were just an ageing thing and that it was signs of wear and tear. Acupuncture showed her that this is not necessarily the case and that it is still possible to improve on the quality of her life. 

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