Shoulder Pain (Question of Pain Between Fingers)

[Guest guest]

I don't know if this will be helpful in your case or not, but there

is some very interesting info in Giovanni Maciocia's chapter on

Painful Obstruction Syndrome (The Practice of ).

 

There are some very simple tests that can indicate problems in the

Large Intestine, Lung, or Small Intestine. Problems raising the arm

straight out and up from the side of the body (like is done in the

jumping jacks exercise) can indicate a problem in the Large

Intestine meridian. Problems in bending the arm at the elbow and

touching the palm of that hand to the opposite shoulder can indicate

problems in the Lung channel. Problems in moving the arm behind the

back and touching the shoulder blade (scapula) on the other side can

indicate problems in the Small Intestine meridian. (There are

pictures in the book.)

 

Even though Maciocia gives the info for Painful Obstruction Syndrome

(arthritic pain) in the shoulders, I strongly suspect that these

tests may have application in other problems. Certainly in POS pain

in areas besides the shoulders. For example, I cannot touch the

fingers of my right hand to my left shoulder blade. The best I can

do is to get my forearm behind my back at waist level. I can't move

it any higher, and there's some pain involved in just getting my

right arm behind my back at waist level. (Problem in the Small

Intestine channel.) I do a lot better with the left arm most of the

time than with the right though I can't get the left hand quite as

high as in the picture. In my case it wasn't my shoulder that hurt

but my head (and the back of my neck). The interesting thing is that

the headaches were far more frequent on the right side than on the

left. And the ones on the right were far more severe than the ones

on the left.

 

Points on the Bladder meridian (in particular Bl-23) knocked the

headaches out, but working points on the Small Intestine meridian is

what reduced the tendency to the headaches. What I did is pretty

much what Maciocia recommends. Note what points along the meridian

are tender (in my case the area along part of the course of the

meridian felt cold) and work the tender points (in my case

acupressure to Small Intestine-3 (even though it was not tender but

cold) and heat applied to the part of the meridian that felt cold.

 

Maciocia writes, " It cannot be overemphasized how important it is to

choose the local points according to the involved channel

(identified by checking for tenderness on pressure) and not

according to preconceived ideas about certain points. For example,

L.I.-15 Jianyu is certainly the most important local point for the

shoulder joint, but if only the point T.B.-14 Jianliao is tender on

pressure, then the latter should be used and not L.I.-15. It is an

extremely simple rule, but one that is frequently forgotten in

practice. (The Practice of , pp. 592-593.) (In the

Foundations of , p. 441 (older edition), Maciocia

also talks about the importance of checking both L.I.-15 and T.B.-14

for tenderness when there is pain in the shoulder, and choosing T.B.-

14 if it's sore.)

 

Use the simple tests he gives to determine if there may be a problem

in the Large Intestine, Lung, and Small Intestine meridian. If a

test is positive, check for sore points along the course of the

meridian. In the case of shoulder pain, also check the T.B.- 14

point. (Triple Burner.)

 

When there is acute pain in the shoulder, the use of distal points

is " primary " . (Practice, p. 592.) The main one for acute shoulder

pain is ST-38 Tiaokou (Stomach-38). It's worked " vigorously for a

few minutes while the patient gently rotates the shoulder joint " .

(p. 592.) " If the main area of pain is along the Small Intestine

channel, the distal point to use is BL-58 Feiyang, with exactly the

same technique as for ST-38. " (p. 592) After the appropriate distal

point is worked, the local points that are sore are worked.

 

The distal points for chronic pain are different from those for

acute pain. Maciocia gives the following points in The Practice of

(p. 594): Large Intestine: LI-1 or LI-4 or Lung-7.

Lung: Lu-7. Small Intestine: SI-3 or SI-1. Triple Burner: TB-1 or TB-

5. These point are worked not as vigorously as in the case of the

distal points for acute pain. After the dital points are worked, the

appropriate local points also are worked.

 

I believe that those simple tests can reveal more than just the

channel involved in shoulder pain. In some cases they can reveal

channel involvement in POS in other parts of the body along the

course of the meridian. They also can reveal a tendency to problems

in a particular channel.

 

Maciocia listed 5 etiology factors for pain in the shoulder:

 

1. Cold invading the shoulder meridians. (p. 591.)

 

2. " Excessive work or exercise " . (p. 591.) I want to stress this one

because it's often overlooked when people have headaches. In some

people overusing an arm will result not so much in shoulder pain but

in a headache on that side of the body. Maciocia mentioned

repetitive motion over a period of years, but in predisposed

individuals any time the person overuses the arm, the person gets

shoulder pain and/or a headache. What constitutes " overuse " for a

susceptible person may not be overuse for a person who is not

predisposed. Overuse of an arm like Cold triggers a local Qi

Stagnation which manifests as pain.

 

3. Accidents. (p. 592.) Maciocia writes that the mild ones can cause

Qi Stagnation, and the severe ones can cause Blood Stasis. (p. 591.)

He also mentions that just because the shoulder appears healed by

the standard Western tests, that doesn't mean that the Blood Stasis

has been resolved. That can continue for years after the accident.

I also want to mention that surgery can trigger this type of Blood

Stasis too.

 

4. Gall Bladder Problems (p. 592.) " In a small number of cases, a

problem in the Gall-Bladder (such as Damp-Heat) can affect the Small

Intestine and Gall-Bladder channels in the shoulder and cause

referred pain in the shoulder joint. " (p. 592.) He's talking about

problems in the Gall Bladder Organ affecting the Small Intestine and

Gall Bladder meridians in the shoulder. I want to remind readers

that TCM Organs are not equivalent to anatomical organs. A lot of

readers are familiar with the way that pain from passing a gall

stone can radiate to the right shoulder. Because he's talking about

the Gall Bladder (TCM Organ) and not just the gall bladder

(anatomical organ), the left shoulder also could be affected. But if

it is the anatomical gall bladder, the pain will be in the right

shoulder, and it can be rather extreme (to put it mildly) though not

as extreme as the pain in the middle of the trunk of the body on the

right side. (Something else to be aware of when it's the gall

bladder is that the person prefers sitting up and even moving around

to lying down because it lessens the pain a little. The person may

be rocking back and forth in order to lessen the pain a little. The

doctor will then differenciate between gall stones and the

possibility of a kidney stone by asking if the pain is more severe

in the front or in the back. The pain may be so severe and so

radiating that a person may have trouble identifying if it hurts

more toward the front of the body or toward the back.)

 

5. " Large Intestine Problem " (p. 592.) This is another example of an

Organ imbalance manifesting in the meridian. As in the case of the

Gall Bladder/ gall bladder, there can be some overlap between the

Large Intestine and the large intestine. In the case of the overlap

between the Gall Bladder and the Gall Bladder (and Small Intestine)

meridians, the usual reason is a gall stone and/or inflammation of

the gall bladder. In the case of overlap between the Large Intestine

and large intestine and problems manifesting in the Large Intestine

meridian, the problem often is constipation or colonic inertia. (The

Spleen often also is involved.) One of the things which may be

happening from a Western anatomical and physiology standpoint is

that incomplete digestion of protein (digestion is primarily a Spleen

(-Pancreas) function in TCM) results in a build-up of histamine.

That's a chemical which is responsible for many allergic reactions.

It's usually produced in allergic reactions, but it also can be a by-

product of incomplete protein digestion. The effects can be

particularly bad when the waste material in the intestional tract is

stagnating instead of moving through quickly. Regardless of how

histamine is produced, it has the same reaction on the body:

Inflammation and swelling. And if it's in the large intestine, its

effects also can manifest in the Large Intestine meridian. There can

be POS pain anywhere in the body, but it particularly will manifest

along the course of the Large Intestine (and/or the Small Intestine

meridian is the small intestine is affected). Both these meridians

run along the arms, so pain is more likely in certain fingers, the

arms, the elbows, and the shoulders.

 

For decades the official line from the Western medical establishment

has been that it's not necessary to have a bowel movement every day

or even every two to three days. Unfortunately this often gets

misinterpreted to mean not a once in a great while thing but a

regular thing. When a person is experiencing constipation and/or

colonic inertia and/or irregular bowel movements as a regular thing,

it does make a difference in how well the person feels and how

healthy the person is. Healers, you will encounter clients who have

noticed that their problems with arthritis/ Painful Obstruction

Syndrome are less or even non-existent when their bowel movements

are regular. It's not their imagination, it's not a psychological

thing, there are physiological reasons for this.

 

Sometimes it's a sensitivity to a particular food. In a previous

post I talked about the problem that some arthritis sufferers have

with potatoes and other members of the nightshade family. When there

is Food Stagnation - including a sluggish intestinal tract,

constipation, etc. - on top of the sensitivity to a particular food,

the arthritic problems are going to be even more pronounced than

when the offending food is being eliminated regularly.

 

In case where there is constipation or colonic inertia or sluggish

bowel movements, it's important to identify the TCM Root. Irregular

bowel movements can have one or more of several underlying TCM

Roots. In general, if the feces are hard and dry, this points to

Heat being a problem. If the bowel movements when they do finally

come are mushy, this points to the possibility of a Cold imbalance

and possible Kidney Yang Deficiency and possible Damp Cold. If the

person alternates between hard, small, round feces and diarrhea or

mushy bowel movements, this points to possible Liver imbalance.

Bowel movements that are particularly foul smelling point to Damp

Heat.