Overview
Frozen shoulder joint is a retrograde and inflammatory affection which attacks the soft tissue of shoulder joint, and it is characterized by pare on the shoulder and dyskinesia of the shoulder joint. Its predilection age is 50 years old, the morbidity rate of female is a little higher than male's. In TCM, it is also called "shoulder of 50 years old",” pain on the shoulder and back", "stagnation on the shoulder meridian" or "gouty arthritis". It is caused by chronic strain, tendons and bones injury, deficiency of qi and blood with invasion of the wind, cold and damp pathogens. It is mainly treated by expelling pathogenic wind and cold and removing dampness, activating the blood circulation and dredging the collateral by warming the meridian.

Treatment
1. Tiaokou (ST 38)
Ask the patient to sit in flexion or to lie in a supine position, and to lay the affected site close to the bed edge that is convenient for moving the affected site. A 28 gauge 2-3 cun filiforrn needle is used to puncture ST38. After routine sterilization, puncture the contralateral ST38, or penetrate the ipsilateral ST38 toward BL57. After getting arrival of qi, press the point with the pressing hand. Twirling reducing method is used to guide the meridian-qi conducting upward. Usually the meridian-qi could get to the knee or above the knee, even to the shoulder. At that time ask the patient to move the shoulder, such as waving arms forwards and backwards and rotating arms internal and external. The needle is retained for 15-20 minutes. Manipulations are done 2-3 times with short intervals. The treatment is applied once every day or every other day.

2. Jianling Point
It is an extra point which locates 0.8-0.9 cun below Yinlingquan SP 9 and has tenderness. In treatment, the contra lateral point is selected. Combination of twirling method with lifting and thrusting method is applied to get arrival of qi. Manipulations are done 1-2 times continuously. Reinforcing and reducing therapy or even method is applied according to excessive or deficient conditions. The treatment is applied once every day, 7 times for one course, and 3-5 intervals between two courses.

3. Jianzhou Point
It is an extra point which locates about 1 cun inferior to Zusanli ST36. In treatment, the contra lateral point is selected. Puncture perpendicularly 1-2 cun. Reducing method with strong stimulation is applied for the patient with excess syndrome. Manipulation is done strongly by lifting-thrusting and twirling the needle upwards and downwards; reducing method by mild stimulation is applied for those having weak constitution with long duration. The puncturing lasts 1-2 minutes, until the pain alleviated when the patient lift and abduct the shoulder with flexible activities. For dyskinesia caused by adhesion of local tissues, the needle is retained for 20-30minutes. Manipulation is done every 5 minutes, 7 times for one course.

4. Jianyu (LI 15)
Penetrating LI15 to HT1 therapy is applicable. It locates antero-inferior to the acromion, in the middle of the upper portion of deltoideus. When the arm is in full abduction, the point is in the introcession appearing at the anterior border of the acromioclavicular joint. Puncture perpendicularly into the introcession 3-4 cun, and manipulates the needle with reducing therapy by twirling or lifting and thrusting the needle at first, then apply the acupuncture manipulation for inducing a sensation of hot or reinforcing therapy by twirling the needle, until getting the needling sensation of sour and distension or warm and heat, and the sensation should be radiated to the neck and arms, retain the needle for 15-20 minutes.

5. Ashi Point
Application of point injection therapy on the local shoulder joint where has the most sensitive tenderness. The 10% glucose injection or Vitamin B1 injection or Danggui injection 0.5 ml can be injected once every other day, and 10 times for one course. For the patients who have severe pain on the shoulder, 1-2 mg dexamethasone injection added with 1% procaine hydrochloride 1 mg is injected with a 5-6 gauge injector, insert the needle quickly, then inject the lotion until the tip get to the site between the periost and muscle tendon or the ligament, 0.5-1 ml injection is used each time, and treat the patient once every week.

Note
1. Acupuncture therapy has significant effect for this disease, but the treating opportunity should be grasped properly. Usually the shorter course the better effect, combination of 1-2 kinds of therapies can be used for the patients whose have long courses. For the patients who suffer from tissue adhesion and muscular atrophy, massage therapy is applied to enhance the curative effect.

2. Pay attention to warm the shoulder in daily life, avoid invading by wind-cold pathogen, and do some practices of shoulder muscles to prevent this disease. The patient should do functional practices while having treatment.