Acupuncture for Shoulder Pain: Evidence

Check the cause first

Shoulder pain has many causes. The NHS lists sudden very bad pain where you cannot move your arm, sometimes with a changed shape, among causes such as a dislocated shoulder or broken bone. [1] That needs urgent medical care, not acupuncture; in the United States, call 911 in an emergency. The NHS advises getting medical help if shoulder pain does not start feeling better after 2 weeks. [1]

The short answer

Acupuncture for shoulder pain has been studied less than for back pain or knee osteoarthritis. The reviews we read are small, vary in quality and mix different conditions. A few suggest pain relief, but none gives a firm answer. Evidence label: insufficient evidence to promising but limited, depending on the condition. Background on how to read these trials is on what is acupuncture.

Evidence by shoulder condition

1. Mixed shoulder disorders (Cochrane, 2005)

   Insufficient evidence

   9 trials of varying quality; little evidence to support or refute, possible short-term benefit [2]

2. Shoulder impingement (2024)

   Promising but limited

   5 randomized trials of manual acupuncture; pain and function improved, but few patients and mixed results [3]

3. Frozen shoulder (2024)

   Promising but limited

   13 studies; acupuncture plus physical therapy beat physical therapy alone for pain, with considerable heterogeneity [4]

4. Shoulder pain after stroke (2016, 2023)

   Insufficient evidence

   Added to rehabilitation, some benefit but inconclusive; similar to rehabilitation alone when compared head to head [5][6]

Mixed shoulder pain: the older Cochrane review

The Cochrane review included nine trials of varying methodological quality. [2] Its authors concluded that there is little evidence to support or refute acupuncture for shoulder pain, though there may be short-term benefit. [2] In rotator cuff disease, the benefit over placebo seen at four weeks was, by four months, no longer likely to be clinically significant. [2] This review is from 2005, so newer trials are not in it.

Shoulder impingement

A 2024 review looked only at manual acupuncture (no electrical or other variants) for shoulder impingement syndrome and found five randomized trials. [3] The authors concluded manual acupuncture is effective for pain and shoulder function, but said further research is necessary because of the limited number of patients and differences between studies. [3] We cannot tell from the abstract how well the sham comparators protected against placebo effects.

Frozen shoulder

In 2024, a review of 13 studies compared physical therapy with and without acupuncture. [4] It included randomized, quasi-experimental and nonrandomized studies. [4] Combined treatment reduced pain more than physical therapy alone, though results varied a lot between studies. [4] That design cannot separate the effect of the needles from the effect of extra treatment time and attention. The NHS says frozen shoulder can take months or years to get better, but pain and stiffness usually go away eventually. [7]

Shoulder pain after stroke

A 2016 review found 12 randomized trials. [5] It said there is some evidence for an effect on shoulder pain after stroke, but the results are inconclusive. [5] A 2023 review found acupuncture similar to rehabilitation therapy for shoulder pain. [6] In it, fourteen studies did not mention adverse events from acupuncture, [6] so safety reporting is thin. Stroke recovery generally is covered on acupuncture for stroke recovery.