The patient was interested in acupuncture, and told me that he felt like he was grasping at straws. He had tried more conventional forms of treatment including drugs, exercises and various forms of physical therapy. He had had shoulder pain and restricted movement for several years.

He had received conflicting opinions from the two orthopedic surgeons he had consulted. One said he should have rotator cuff surgery. When he consulted another orthopedic surgeon, he was told that his rotator cuff was intact and that surgery would not likely be helpful for him.

As we discussed his condition, I gathered that his impression was that acupuncture was a strange treatment that was akin to spreading chicken feathers, shaking a rattle or a shrunken head. But since he had found no relief through conventional treatments, he was “ready to try anything”.

I began with a health history and a physical examination to determine whether I thought acupuncture would be helpful for him.

He was unable to raise his right arm higher than his shoulder. When he tried to lift it higher, his shoulder joint failed to move and he compensated by simply leaning to the opposite side. He winced when he exerted this effort. He could not reach behind his back with the affected arm.

He told me that when he tried to reach behind the passenger seat when he drove that he would go weak with pain.

As a test, I briefly applied firm pressure to two specific points near his right shoulder. I then asked him to repeat the restricted motions.

His eyes grew wider as he realized he could immediately raise his arm thirty degrees higher than before and could even place his hand behind his back to some degree without pain.

“How did you do that?” he asked. “I haven’t been able to get my arm that high in years.”

I explained that in his case, the reason his shoulder movement was restricted appeared to be due to two specific muscles that were locked in a state of contracture due to an old injury. Since the muscles never fully relaxed, the shoulder movement was restricted and painful.

One interesting aspect of acupuncture is that it can be extremely successful at restoring movement to an impaired joint in cases such as this. The needles are inserted into specific points in the contracted muscles and stimulated in such a way that the contracture begins to relax. In cases that have been present for even a decade or longer this effect can be produced.

There is nothing really unconventional about using acupuncture needles in this way. It has been done by numerous clinicians in the United States for decades. In fact, President Kennedy’s private physician, Janet Travell, MD, pioneered the procedure in the 1950’s. Many researchers, clinicians, and scientists have contributed refinements and modifications to the approach since that time.

This use of acupuncture, sometimes called intramuscular needling, is used successfully in clinicians’ offices every day to help resolve long-standing cases of joint pain and dysfunction.

As I worked with the patient over the next few weeks, he made very good progress. Within a short time he had recovered full, pain-free range of motion in the affected shoulder. He told me he was telling anyone that would listen about his recovery.

In many cases of joint pain, even in cases where arthritis may be suspected, the underlying cause of pain and impairment is one or more muscles that are not functioning properly. In many cases the originating cause is likely an injury long forgotten.

This principle applies to all joints, including shoulders, elbows, hips, knees, spine and other joints.

One common aspect of this type of condition is that the patient often cannot pinpoint the exact origin of the pain. The pain is usually dull and achy. Pain may vary in location from time to time.

Dr. Mark Kestner