Musculoskeletal Conditions


Acupuncture treatment for a frozen shoulder.Musculoskeletal conditions encompass a very wide array of problems, but for simplicity I shall exclude under this category, both injuries and arthritis; for help with them, please click on their specific headings. Under the musculoskeletal heading, I am going to give you an introduction to how acupuncture approaches conditions as diverse as frozen shoulder, stiff neck, tight shoulders, trapped nerves, carpal tunnel syndrome, knee pain, foot pain, fibromyalgia and other chronic pain conditions. 

A large review funded by the National Institute for Health & Care Research in 2017, concluded that acupuncture is better than usual care for pain from musculoskeletal conditions.

Your First Consultation

In our first consultation, I need to establish when the problem began, whether you feel it was triggered by a particular event, or whether it has crept on gradually. Then there are some other things for you to think about. Do you feel pain all of the time, or only on certain movements? Is your range of movement restricted, and if so, how eg. a frozen shoulder might be preventing you from reaching into a back pocket or brushing your hair? Is the pain sharp or shooting, or does it feel more dull and heavy? Have you found it responds to movement, rest or warmth? Does the pain spread some distance from where you feel the focus of the problem lies eg. pain which radiates from your shoulder to your elbow or beyond?

Next I will gather information on your health and wellbeing more generally, and note any other medical conditions which you have, or have had, in the past. We will move on to a thorough physical examination of the affected area and its surroundings, including assessing your range of movement and checking for tender areas. I can then give you your first treatment, aimed not only at helping the problem directly, but also at assisting with any subtle underlying imbalances which may have been perpetuating it: even stress may be one such factor.


Robin Costello treating a shoulder problem in Kunming Hospital, China

My treatments for musculoskeletal problems are likely to involve a combination of massage and acupuncture, with exercises for you to perform at home. Generally, the longer a condition has persisted, or the more severe it is, the more treatment will be required. Some change is usually experienced after four or five treatments, but fairly recent problems treated early, can respond more quickly. I will usually suggest an initial number of sessions, after which we will review progress.

Do not worry if I have not listed your specific musculoskeletal problem (there exist a great many), or if you have not to date had a clear diagnosis. You are always welcome to telephone to discuss it.

Below you can read the results of some of the research which has been undertaken into acupuncture for musculoskeletal problems. The trials vary in quality, but systematic reviews and randomised controlled trials are generally considered to provide the highest quality evidence. If you would like to read more about evidence quality, I would refer you to the British Acupuncture Council’s description of the evidence pyramid.

Acupuncture helps Fibromyalgia Pain

Acupuncture helps fibromyalgia pain. American researchers report that electro-acupuncture helps fibromyalgia pain, by altering the way the brain’s amygdala connects with its representation of the body. A total of 76 fibromyalgia patients were randomised to receive either electro-acupuncture or mock laser acupuncture, twice a week for a total of eight treatments. Functional brain network connectivity was assessed using resting state functional magnetic resonance imaging (MRI), and proton magnetic resonance spectroscopy, before and after treatment.

The electro-acupuncture group experienced a greater reduction in pain severity compared with the control group, and increased levels of an inhibitory neurotransmitter in the anterior insula, a small region of the cerebral cortex responsible for sensory processing. The researchers conclude that acupuncture can modulate functional connectivity and inhibitory neurochemistry, leading to reduced pain severity.

(Greater Somatosensory Afference With Acupuncture Increases Primary Somatosensory Connectivity and Alleviates Fibromyalgia Pain via Insular Gamma-Aminobutyric Acid: A Randomized Neuroimaging Trial. Arthritis & Rheumatology, July 2021.)

Acupuncture and Fibromyalgia

Acupuncture in Exeter: acupuncture and fibromyalgia. An Italian team at the University of Verona, researching acupuncture and fibromyalgia, have shown it represents an effective treatment option. They also studied the effectiveness of a group of nutritional supplements.

A total of 60 women with fibromyalgia were randomised to receive either acupuncture, or a nutritional supplement. The latter, known as Migratens, included coenzyme Q10, vitamin D, alpha-lipoic acid, magnesium and tryptophan. Both treatments were given for three months, with pain and quality of life being assessed at the end of months 1, 3 and 6.

Positive results were found for both interventions. Nutritional therapy was associated with statistically significant pain reductions one month after starting, and further improvements continued to be seen at the three month point. These benefits diminished however, once treatment was suspended. Acupuncture was also associated with improvements at all time points during treatment, but some improvement was still maintained three months after the end of treatment. Comparing the two groups, acupuncture was associated with the greater pain reduction at all time points. Quality of life also improved in both groups, but only in the acupuncture group did it reach statistical significance.

(Comparison between Acupuncture and Nutraceutical Treatment with Migratens in Patients with Fibromyalgia Syndrome: A Prospective Randomized Clinical Trial. Nutrients Journal, 19 March 2020.)

Acupuncture helps Tennis Elbow

Acupuncture treatment for a frozen shoulder. An international team has shown that acupuncture helps tennis elbow, and can improve both pain and function. A total of 96 patients, aged 18 to 80, with chronic unilateral tennis elbow, were randomised to receive either true acupuncture or a sham laser treatment as a control. Both groups received three sessions per week for three weeks, at centres in Italy, Australia, Hong Kong and China.

At post-treatment follow-up, the researchers found significant differences in disability and pain scores between the two groups, in favour of true acupuncture. At all time points measured, the acupuncture group contained a greater number of subjects reporting pain relief in excess of 30%.

(A multi-center international study of Acupuncture for lateral elbow pain – Results of a randomized controlled trial. European Journal of Pain, 17 April 2020.)

Acupuncture for Severe Fibromyalgia

Acupuncture for severe fibromyalgia. Italian researchers have shown that a course of acupuncture for severe fibromyalgia, is effective for treating multiple mental and physical symptoms. In the study, 102 patients with chronic, treatment-resistant fibromyalgia, and attending as out-patients of a rheumatology clinic in Ancona, received eight acupuncture sessions on a weekly basis. All participants were allowed to continue drug therapy.

After the eight weeks, patients experienced significant improvements in all evaluated parameters, including fibromyalgia impact, neuropathic pain, pain catastrophising and global health. The researchers say that for the first time, acupuncture has been shown to be effective against disease features such as pain catastrophizing and neuropathic pain. Earlier intervention with multimodal strategies, including acupuncture, could be of great benefit to patients.

(Acupuncture for Fibromyalgia: An Open-Label Pragmatic Study on Effects on Disease Severity, Neuropathic Pain Features, and Pain Catastrophizing. Evidence-Based Complementary & Alternative Medicine, 25 February 2020.)