Chronic
Distal Points
In the treatment of chronic shoulder pain, distal points are also used but they are stimulated with
less intensity or not at all. The choice of distal points depends on the channel involved:
- Large Intestine: L.I.-1 Shangyang or L.I.-4 Hegu. LU-7 Lieque can also be used.
- Lung: LU-7 Lieque.
- Small Intestine: S.I.-3 Houxi or S.I.-1 Shaoze.
- Triple Burner: T.B.-1 Guanchong or T.B.-5 Waiguan.
These distal points are stimulated with moderate intensity and the local points are inserted
immediately after the distal ones.
Local Points
The local points to use are the same as for acute cases. In chronic cases, it is usually important to
use the points along the Small Intestine channel if they are tender on pressure. So, even though
the patient may not complain of pain in that area, they should always be checked for tenderness
on pressure.
Case History 23.6
Painful Obstruction Syndrome: Cold-Male, Age 58
A 58-year-old man had been experiencing pain in both shoulder joints for the previous 4 years.
He had been working as a car mechanic for over 25 years. The pain was aggravated by exposure
to cold. The points L.I.-15 Jianyu were tender on pressure. He did not present any other
symptoms and was otherwise a very healthy and strong man.
Diagnosis This an example of Cold Painful Obstruction Syndrome. There is,
however, the additional component of stagnation of Qi in the shoulders
from over-use of the joints through his work as a car mechanic. This is
evidenced by the fact that both shoulders are equally affected. If the
pain is due purely to Painful Obstruction Syndrome, usually only one
shoulder is affected or, at least, one shoulder is definitely worse than the
other.