Acute
Distal Points
Distal points are primary in the treatment of acute shoulder pain. They are manipulated strongly
in order to remove obstructions from the channel involved. After manipulating the distal points,
local points can be used. The main distal point for acute shoulder pain and stiffness is ST-38
Tiaokou. This point is needled on the same side as the affected shoulder and is manipulated
vigorously for a few minutes while the patient gently rotates the shoulder joint. If movement of
the joint is severely impaired, it is preferable that a third person holds the patient's arm by the
elbow and gently helps him or her to rotate the shoulder.
If the main area of pain is along the Small Intestine channel, the distal point to use is BL-58
Feiyang, with exactly the same technique as for ST-38.
After manipulating the distal point as described above, local points are used with warming
needle if necessary. The choice of local points is made according to the distribution of pain along
a certain channel. If the shoulder is stiff, the channel involved can also be identified according to
the particular movement that is inhibited. If the patient cannot raise the arm sideways, it
indicates that the Large Intestine channel is involved (Figure 23.5(458)).
If he or she cannot touch the opposite shoulder joint, then the Lung channel is probably affected
(Figure 23.6(459)).
If he or she cannot twist the arm backwards over the scapula, it denotes involvement of the Small
Intestine channel (Figure 23.7(460)).
Local Points
With the aid of the above techniques, careful observation of the distribution of pain and pressing
the points checking for tenderness, the involved channel can be identified and the local points
chosen.
It cannot be overemphasized how important it is to choose the local points according to the
involved channel (identified by checking for tenderness on pressure) and not according to
preconceived ideas about certain points. For example, L.I.-15 Jianyu is certainly the most
important local point for the shoulder joint, but if only the point T.B.-14 Jianliao is tender on
pressure, then the latter should be used and not L.I.-15. It is an extremely simple rule, but one
that is frequently forgotten in practice.