Efficacy of Acupuncture for Shoulder Pain Based on Remote Point Selection According to the Meridians

This double blind randomized controlled trial investigates the immediate efficacy of acupuncture for shoulder pain using remote point selection based on meridian theory. A total of 90 participants with shoulder pain (Numerical Rating Scale ≥ 4) will be randomly assigned in a 1:1:1 ratio to one of three groups: acupuncture SC, acupuncture CS, and rehabilitation. Meridian selection will be determined based on the patient's most painful shoulder movement and corresponding pain location, followed by standardized distal acupoint application. Outcome measures include changes in pain intensity (NRS) and shoulder range of motion assessed at baseline, post-first acupuncture, post-second acupuncture, and 30 minutes post-treatment. Blinded evaluators will conduct all assessments. The study aims to assess the effectiveness of meridian-based remote acupuncture and explore its relationship with shoulder movement patterns and soft tissue involvement.

Study Overview

• Status: Not yet recruiting
• Conditions: Shoulder Pain; Acupuncture; Meridians
• Intervention / Treatment: Procedure: Acupuncture; Procedure: Rehabilitation

• Study Type: Interventional
• Enrollment (Estimated): 90
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Shih-Liang Yang; Phone Number: 6102 +886-4-22294411; Email: YSL451YSL@yahoo.com.tw
• Study Contact Backup: Name: Dong-Sheng Yang; Phone Number: 6122 +886-4-22294411; Email: dawndawn0226@gmail.com

Study Locations

• Taiwan
  • Taichung, Taiwan, 403
    • Taichung Hospital, Ministry of Health and Welfare
    • Contact: Shih-Liang Yang; Phone Number: 6102 +886-4-22294411; Email: YSL451YSL@yahoo.com.tw
    • Principal Investigator: Shih-Liang Yang
    • Sub-Investigator: Dong-Sheng Yang

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Participants must be at least 18 years old.
• Shoulder pain persisting for at least one week.
• Numerical Rating Scale (NRS) score ≥ 4.

Exclusion Criteria:

• Patients with cervical radiculopathy or other localized neurological disorders affecting the upper limb.
• Psychiatric disorders that may interfere with examination, treatment, or evaluation of disease progression.
• Pregnant patients.
• Inability to provide informed consent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Acupuncture SC Group; The most affected meridian is determined based on location and movements. The physician first applies acupuncture to one standardized acupoint (LI10, TE7, SI7, or LU6) on the most affected meridian. After 3 minutes (3 minutes after the first acupuncture), the assessor performs the first evaluation. The physician then applies acupuncture to a controlled acupoint (PC6) not directly related to shoulder function. After another 5 minutes (8 minutes after the first acupuncture), the assessor performs the second evaluation. The final evaluation is conducted 30 minutes after the first acupuncture. The patient is instructed to perform shoulder movements throughout the treatment.	Procedure: Acupuncture; In this study, both the acupuncture SC group and the acupuncture CS group will receive two acupuncture treatments in one session. The SC group will first receive acupuncture at the standardized acupoint followed by the controlled acupoint, while the CS group will first receive acupuncture at the controlled acupoint followed by the standardized acupoint.
Experimental: Acupuncture CS Group; The most affected meridian is determined using the same method by location and movements. The physician first applies acupuncture to the controlled acupoint (PC6). After 3 minutes, the assessor performs the first evaluation. The physician then applies acupuncture to one standardized acupoint (LI10, TE7, SI7, or LU6) on the most affected meridian. After another 5 minutes (8 minutes after the first acupuncture), the assessor performs the second evaluation. The final evaluation is conducted 30 minutes after the first acupuncture. The patient is instructed to perform shoulder movements throughout the treatment.	Procedure: Acupuncture; In this study, both the acupuncture SC group and the acupuncture CS group will receive two acupuncture treatments in one session. The SC group will first receive acupuncture at the standardized acupoint followed by the controlled acupoint, while the CS group will first receive acupuncture at the controlled acupoint followed by the standardized acupoint.
Active Comparator: Rehabilitation Group; Participants will complete a 30-minute rehabilitation session, followed by an outcome assessment.	Procedure: Rehabilitation; Participants will complete a 30-minute rehabilitation session, which includes electrotherapy and thermotherapy applied to the shoulder.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity (Numerical Rating Scale, NRS: 0-10)	Patients will be asked to rate their pain intensity using a numerical scale. 0: No pain. 1-3: Mild pain - the patient feels pain but can tolerate it; normal daily activities and sleep are not disturbed. 4-6: Moderate pain - the pain is noticeable and difficult to tolerate; sleep may be disturbed, such as waking up due to pain; patients may request pain medication. 7-10: Severe pain - the pain is intense and intolerable; sleep is severely disturbed or impossible; pain medication is often necessary.	Baseline evaluation before intervention. First evaluation: 3 minutes after the first acupuncture. Second evaluation: 3 minutes after the second acupuncture (8 minutes after the first). Final evaluation: 30 minutes after the first acupuncture.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Range of Motion	A goniometer will be used to measure the range of motion of the affected shoulder joint in the following movements: flexion, abduction, external rotation, and internal rotation.	Baseline evaluation before intervention. First evaluation: 3 minutes after the first acupuncture. Second evaluation: 3 minutes after the second acupuncture (8 minutes after the first). Final evaluation: 30 minutes after the first acupuncture.

Collaborators and Investigators

• Sponsor: China Medical University Hospital

Publications and helpful links

General Publications

• Chandran KP, Chandran PP, Arumugam N, Muthappan S. Effect of Remote and Local Acupuncture Points on Periarthritis of Shoulder: A Comparative Study. J Acupunct Meridian Stud. 2021 Feb 28;14(1):13-20. doi: 10.51507/j.jams.2021.14.1.13.
• Chen IW, Liao YT, Tseng H, Lin HC, Chou LW. Pain, function and peritendinous effusion improvement after dry needling in patients with long head of biceps brachii tendinopathy: a single-blind randomized clinical trial. Ann Med. 2024 Dec;56(1):2391528. doi: 10.1080/07853890.2024.2391528. Epub 2024 Aug 14.
• Takakura N, Takayama M, Kawase A, Kaptchuk TJ, Kong J, Vangel M, Yajima H. Acupuncture for Japanese Katakori (Chronic Neck Pain): A Randomized Placebo-Controlled Double-Blind Study. Medicina (Kaunas). 2023 Dec 9;59(12):2141. doi: 10.3390/medicina59122141.
• Calamita SAP, Biasotto-Gonzalez DA, De Melo NC, Fumagalli MA, Amorim CF, de Paula Gomes CAF, Politti F. Immediate Effect of Acupuncture on Electromyographic Activity of the Upper Trapezius Muscle and Pain in Patients With Nonspecific Neck Pain: A Randomized, Single-Blinded, Sham-Controlled, Crossover Study. J Manipulative Physiol Ther. 2018 Mar-Apr;41(3):208-217. doi: 10.1016/j.jmpt.2017.09.006.
• Ben-Arie E, Kao PY, Lee YC, Ho WC, Chou LW, Liu HP. The Effectiveness of Acupuncture in the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2020 Sep 25;2020:9790470. doi: 10.1155/2020/9790470. eCollection 2020.
• Green S, Buchbinder R, Hetrick S. Acupuncture for shoulder pain. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD005319. doi: 10.1002/14651858.CD005319.
• Schroder S, Meyer-Hamme G, Friedemann T, Kirch S, Hauck M, Plaetke R, Friedrichs S, Gulati A, Briem D. Immediate Pain Relief in Adhesive Capsulitis by Acupuncture-A Randomized Controlled Double-Blinded Study. Pain Med. 2017 Nov 1;18(11):2235-2247. doi: 10.1093/pm/pnx052.

Study record dates

Study Major Dates

• Study Start (Estimated): April 18, 2025
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2026

Study Registration Dates

• First Submitted: April 15, 2025
• First Submitted That Met QC Criteria: April 15, 2025
• First Posted (Actual): April 22, 2025

Study Record Updates

• Last Update Posted (Actual): April 24, 2025
• Last Update Submitted That Met QC Criteria: April 22, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Keywords: Acupuncture; Shoulder pain; Meridians
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Joint Diseases; Arthralgia; Shoulder Pain
• Other Study ID Numbers: CMUH113-REC3-192

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared due to institutional policy and data privacy considerations. The study data include sensitive health information that cannot be fully de-identified, and there are currently no resources allocated for managing data sharing requests.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No