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Abstract: The patient, Auntie Wang, 50 years old, presented with vague swelling and pain in the left shoulder 1 month ago, the pain was still tolerable. 1 week ago, the pain worsened, and the posterior extension of the left shoulder was limited, which was aggravated by cold. After treatment with acupuncture, tui-na and oral medication, the patient’s condition was basically stable, and the symptoms of shoulder joint pain and movement disorder improved significantly.
Basic information】Female, 50 years old
Type of disease】Cold syndrome (wind-cold syndrome)
Hospital】Qilu Hospital of Shandong University
Consultation time】December 2019
【Treatment plan】Acupuncture treatment (shoulderzhen point, dazhi point, tianzong point, shoulder front point) + acupoint tui-na (ayi point) + oral medication (Fangfeng Tang plus reduction)
【Treatment cycle】Acupuncture and tui-na treatment 2 times, during which oral medication was taken
【Treatment effect】The condition was basically stable, and the symptoms of shoulder joint pain and movement disorder improved significantly
I. Initial consultation
Patient Auntie Wang, 50 years old, presented a painful face, with normal body shape and nutrition. She reported that she had a vague swelling and pain in her left shoulder 1 month ago, but the pain was tolerable and was not treated. One week ago, the pain suddenly worsened and the posterior extension of the left shoulder was restricted, which was aggravated by cold. The patient usually worked hard, and her left shoulder was unconsciously elevated at work, accompanied by cold after blowing air conditioning. On physical examination, there were more pressure points in the left shoulder joint on palpation, and the shoulder mobility examination showed that the left shoulder joint was restricted, especially posterior extension, while the right shoulder joint was normal. The patient was mentally well, cold and painful, afraid of wind, poor sleep, and thin white tongue coating.
II. Treatment history
Since the main symptoms of the patient’s wind-cold syndrome were in the shoulder, the main treatment principle was to relieve the patient’s shoulder symptoms. The patient was given massage therapy for the left shoulder joint, taking the A-Yi point and using the One Finger Zen technique to push firmly and move slowly for 3-5 minutes. Acupuncture treatment was then given to the patient. The acupuncture points of Shoulderzhen, Dazhong, Tianzong, and Qianshou were selected, and the patient felt soreness and swelling for 30 minutes after local sterilization. The acupuncture and tui-na treatment should be performed twice, together with exercise, such as forward flexion, abduction, supination and back extension. During the treatment period, the patient should also be given oral treatment with the addition and subtraction of Fangfeng Tang to dispel cold and relieve pain, dispel wind and remove paralysis.
III. Treatment effect
The patient’s left shoulder joint pain and restricted movement symptoms were significantly relieved after treatment. After the first treatment of tui na, acupuncture, medicine and functional exercise, the patient’s left shoulder joint pain was reduced because the treatment method had the effect of soothing the meridians and dispersing cold, but there were still symptoms of limited movement of the left shoulder joint. After the second treatment, the patient’s left shoulder joint pain symptoms basically disappeared, and the symptoms of limited left shoulder movement improved significantly, so he could resume normal life and work. The treatment effect was good and the patient was satisfied, so the drug was discontinued.
IV. Notes
I was very happy that the patient’s wind-cold symptoms were basically relieved after the treatment of acupuncture, massage, medicine and functional exercise. However, the patient still needs to pay attention to the following points in daily life.
1, the patient needs to pay attention to avoid strain and cold in daily life, and increase and decrease clothing according to weather changes in time to avoid aggravation of the disease.
2, patients should adhere to functional exercises, such as stair climbing exercises, after their condition has improved. If symptoms of discomfort appear, they should go to the hospital promptly and give treatment.
3. It is necessary to maintain the correct sitting posture when sitting or standing to avoid local pressure due to imbalance of the shoulder joint.
V. Personal insight
Wind-cold is a common disease in TCM, mostly caused by cold and shoulder joint muscle strain like the patient in this case. However, it should be noted that acupuncture and massage should be performed on the basis of acupuncture points, so as to avoid blindly selecting acupuncture points that may endanger health.