Frozen Shoulder

General

Clinical Manifestations	Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.
Treatment Principle
Herb Formulas
Points

Tai Yang Shang Han Cold

Clinical Manifestations	Chills and fever Anhidrosis Stiff and rigid neck, shoulders and upper back Intolerance of Wind Dislike of Cold Inflammation Diarrhea Muscle spasms Mucosal swelling Nasal congestion Sensitivity to dust Headache Wind-Cold Bi (few joints affected, inflammation intense but short lived, changes over days or weeks) T: Normal C: Thin and white P: Floating and tight
Treatment Principle	Release Wind-Cold in the exterior and muscle layer Generate Fluids Relieve muscle-ache of the neck and shoulder
Herb Formulas	Ge Gen Tang
Points

Tai Yang - Yang Ming

Clinical Manifestations	Chills and fever Anhidrosis Stiff and rigid neck, shoulders and upper back Intolerance of Wind Dislike of Cold Inflammation Vomiting Muscle spasms Mucosal swelling Nasal congestion Sensitivity to dust Headache Wind-Cold Bi (few joints affected, intense but short lived, changes over days or weeks) Inflammation T: Normal C: Thin and white P: Floating and tight
Treatment Principle	Release Wind-Cold in the Exterior and muscle layer Generate Fluids Relieve muscle-ache of the neck and shoulders
Herb Formulas	Ge Gen Jia Ban Xia Tang
Points

Tai Yang - Shao Yang

Clinical Manifestations	Joint pain with a crackling sensation Epigastric pain Fatigue Gastrointestinal weakness Headache Heaviness in the head Fever Moderately severe chills Distension beneath the Heart Periumbilical or lower abdominal pain Tenseness around the pubic bone Subcostal pain Epigastric fullness Nausea Mild vomiting Mild thoraco-costal discomfort Costal distress Tension in the rectus abdominus Chest distension Abdominal pain Abdominal distension Constipation Irritability Insomnia Repeated loss of spinal alignment due to muscular tension P: Floating and weak
Treatment Principle	Release the Exterior and muscle layer Harmonize and release the Shao-Yang Harmonize the Liver, Spleen and Intestines Dispel Water Accumulation
Herb Formulas	Chai HU Gui Zhi Tang
Points

Wind-Cold With Qi And Blood Deficiency And Blood Stasis

Clinical Manifestations	Pain triggered by movement of the shoulder The restriction develops slowly and gradually worsens over time Better during the day and worse at night Sleep disturbance In severe cases a light touch on the shoulder can trigger severe pain The pain radiates to the upper arm, elbow and hand In chronic cases, the muscles around the shoulder may wilt and the sinews may become inflexible This may lead to complete restriction of shoulder movement A Cold feeling in the shoulder Spontaneous sweating in the palms T: Normal C: White P: Thready
Treatment Principle	Eliminate Wind Overcome Dampness Scatter Cold Invigorate the Blood Tonify Qi and Blood Unblock the channels
Herb Formulas	Juan Bi Tang  modified
Points	LI-11, LI-15, SJ-5, SJ-14 For pain along the posterior aspect of the shoulder, along the SI Channel: + SI-3, SI-8 For pain along the posterior aspect of the shoulder, along the LI Channel: + LI-14 For pain along the posterior aspect of the shoulder, along the SJ Channel: + SJ-3, SJ-10 For pain along the anterior aspect of the shoulder: + LI-4, LU-7 For pain that radiates to the upper back and neck: + SI-10, SI-11, SI-14, SI-15 For Qi and Yang Deficiency: + DU-14, LI-4 For pain and numbness in the ring, middle and little fingers: + SJ-3

Wind-Cold Damp Bi

Clinical Manifestations	Acute shoulder pain with a cold, heavy sensation Pain is worse on exposure to Cold, Wind and rainy weather Pain improves with warmth The pain is fixed and worse at night Occasionally a swollen shoulder with restricted movement Purplish or slightly blue facial complexion Heaviness Stiffness Numbness of the fingers T: Pale or slightly purplish C: White and greasy P: Wiry and tight or Slippery and wiry or Rough
Treatment Principle	Dispel Cold Eliminate Damp Circulate Qi Sedate pain
Herb Formulas	Jian Ning San Jia Wei Ge Gen Tang With Qi and Blood Deficiency: Juan Bi Tang #1
Points	GB-20, LI-15, SI-9, SI-11, SJ-5, ST-36, ST-40 For pain that occurs at the place where the Lung channel passes through: + LU-3, LU-4, LU-5 For pain that occurs at the place where the Large Intestine channel passes through: + LI-6, LI-7, LI-14 For pain that occurs at the place where the San Jiao channel passes through: + SJ-7, SJ-14 For pain that occurs at the place where the Small Intestine channel passes through: + SI-4, SI-6 For pain in the scapular region: + SI-10, SI-11 For stiffness and pain in the neck: + GB-21, SI-14 For a headache: + Taiyang, Yintang For nausea and vomiting: + PC-6, REN-12

Blood Deficiency

Clinical Manifestations	Abdominal pain Irritability Slight chills Spasms of the calf muscles Cramps in the hands Weak legs Hypertonicity of the extremities characterized by difficult flexion and extension Wheezing Coughing Hiccup Constipation Vomiting Diarrhea Sciatic pain Severe and painful muscle spasms in the Stomach, bronchi, Gallbladder and uterus. Intestines Shoulder pain Pain in the head, body or limbs due to arterial spasms characterized by a severe pulling pain T: Normal or Reddish C: None or Yellowish P: Wiry and rapid or Thready and rapid
Treatment Principle	Soften the Liver Nourish the Blood Nourish Yin Moderate painful spasms Relieve pain Harmonize the Middle Jiao Replenish Body Fluids
Herb Formulas	Shao Yao Gan Cao Tang
Points

Blood Deficiency Leads To Cold In The Channels

Clinical Manifestations	Long standing cold hands and feet that are cold to the touch and feel cold to the patient Maybe lumbago and leg pain Abdominal pain and distention Midline pain Uterine pain Chills Diarrhea Menstrual abdominal pain Maybe chest pain Increased sweating, particularly of the feet Increased salivation Spasm and pain of the limbs Scanty urination Pain at the waist, hips, legs and feet Sciatica Joint pain Irregular menstruation Abdominal Cold Migraine headache Vaginal discharge T: Pale C: White P: Deep and thready (may be almost imperceptible).
Treatment Principle	Warm the channels Disperse Cold Nourish the Blood Unblock the Blood vessels
Herb Formulas	Dang Gui Si Ni Tang
Points

Phlegm-Dampness In The Upper Jiao Obstructing The Channels

Clinical Manifestations	Pain in the upper arm and shoulder Aches and pains in the wrist, forearm and elbow T: Pink C: Slippery P: Slippery
Treatment Principle	Dry Dampness Transform Phlegm Dispel Wind Dredge the Channels Relieve pain
Herb Formulas	Er Zhu Tang
Points

Wind-Stroke Attacking The Channels

Clinical Manifestations	Arthralgia Whole body numbness and pain Dysphasia Muscle and tendon stiffness and paralysis Leg weakness with difficulty walking Stabbing pain in the hypochondrium Epigastric and abdominal fullness Vomiting Deviation of the eyes and mouth Dyspnea Diarrhea Borborygmus Headache Dizziness Hemiplegia Difficulty walking Aphasia T: Normal C: Frothy or Greasy P: Full/Firm
Treatment Principle	Dispel Wind Promote the circulation of Qi Eliminate Phlegm Dispel Dampness Stop pain
Herb Formulas	Wu Yao Shun Qi San
Points