Case Study: Sore Shoulders from Work

Sore Shoulders from Work

SUMMARY

A patient sought treatment for sore shoulders and neck that she had been suffering from for four months due to working at her computer desk. The patient received 6 treatments with fire cupping and orthopaedic acupuncture over two months, and had relief of her symptoms by the third treatment. After the 6 treatments, the patient returned regularly for maintenance treatments every three to four months.

Patient History

A 42 year old Female patient came to the clinic complaining of soreness in her shoulders for four months. The onset was gradual. The pain is aggravating by working at her desk at work all day, and from scrolling on her cell phone. The soreness is accompanied by tension and an aching sensation. The discomfort is mainly located on the posterior aspect of her shoulders, from her neck towards the lateral aspect of her shoulders. The discomfort is worst at the end of the workday, and is alleviated by massage.

Objective Findings

Upon examining the patient, tight bands were palpated in the upper trapezius, supraspinatus, infraspinatus, and teres minor muscles.

The red oval indicates the area where the patient feels sore. The green triangles indicate the are where tight bands were felt in the trapezius, supraspinatus, infraspinatus, and teres minor muscles.

Passive Range of Motion (PROM) for internal rotation of the shoulders was 45 degrees.

The diagram shows the PROM of the patient’s shoulder (indicated by the red line).

The patient’s tongue was pale red with a blue hue. The tongue coating was white and thicker at the rear of the tongue. There were toothmarks on the left side of the tongue, and a shallow midline crack was also present. The sublingual veins were normal. The pulse was  60 BPM, normal on the right, and deep, thin, and weak on the left.

Diagnosis

Local Qi and Blood Stasis: Repetitive strain from working position

Principle of Treatment

Move local QI and Blood to Stop pain. Modalities: Cupping and Orthopaedic Acupuncture.

Treatment Plan

Treat once a week for 6 weeks.

Results of the first treatment

The patient’s PROM increased by 25 degrees after the treatment, and the patient had relief from the discomfort for 6 days. On the seventh day after the treatment the patient reported having pain in the right shoulder radiating to the right side of the neck. On palpation, tightness was noted in the splenius cervicis muscles. There was seven days between the first and second treatments.

Results from second treatment

The patient felt relief from the second treatment and noted that her neck and shoulder's felt looser. There was no neck pain apparent. There were ten days between the second and third treatments.

Results from third treatment

The patient related that her shoulders have been great since the last treatment with no pain or tension. The patient continued to have zero symptoms throughout the remaining three treatments. The patient continues with maintenance treatments once every three to four months if she feels tension returning to her shoulders from work, to prevent the tension from turning into pain again.