Can I have acupuncture for a frozen shoulder if I am a diabetic?

Q: For over a year now I've been suffering with a frozen shoulder. I went to see a specialist who said I had a nerve problem because the pain moves around my neck, arm and shoulder. The pain was really bad and I couldn't move my arm. I was given Morphine for the pain and a steroid injection into a different part of my shoulder. I also have Type 1 diabetes and thyroid problems. After the injections the pain went but after a few months it's back but not as bad as the first time. The doctor has now told me that because I have Type 1 diabetes I cannot have any more steroid injections, so has prescribed me ibuprofen and advised me to go back and see a physio. But the physio said he can't treat me if I'm in pain and the ibuprofen doesn't work, so I was wondering if I could have acupuncture?

A: The very simple answer is that there is no reason why you cannot have acupuncture as a Type 1 diabetic. The only caution which a practitioner will have is that with Type 1 diabetes there can sometimes be reduced sensitivity to the extremities. In our Guide, which we publish for our members, we say:

Diabetes mellitus It is recommended to ask diabetic patients about neuropathies they may have developed. In severe neuropathies the patient may experience loss of sensation. Due to impaired blood circulation to the affected area the patient may also be at a greater risk of developing a localised infection.  

Needling into the affected area should be done with particular care and strong manipulation of the needle avoided. Patients with poorly controlled diabetes, especially if insulin-dependent, may experience greater than normal fluctuations in blood sugar levels.

As strong acupuncture treatment can lower the blood sugar levels and occasionally induce some drowsiness, it is recommended that you treat such patients with particular care, especially on their first acupuncture treatment, and ensure that they have had something to eat before the treatment.

This just about says it all, really. We have come across the very occasional patient in whom the treatment triggers a release of additional insulin and can steer them towards a hypo, but most long term diabetes patients are usually very much on top of maintaining their sugar balance.

The reason for stopping steroid injections may also be that there is an upper limit beyond which most doctors will not go anyway. Three or perhaps four usually represents the safe number, after which there is an increasing risk of local damage to tissue in the area.

As far as frozen shoulder itself is concerned, as our factsheet shows https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1133-frozen-shoulder.html there is some fairly good evidence that acupuncture can be helpful. This is far from conclusive, so we can't make specific claims, but the evidence does suggest some benefit as well as some reduction in pain. The only problem is that it is difficult to stop someone using the shoulder while it improves, so progress can often be hampered by unintended setbacks when people reach out automatically and trigger pain and discomfort.

The best advice that we can give is for you to visit a local BAcC member for an informal chat. Most are more than happy to give prospective patients some time without charge to take a look at what is going on and will be able to give a better informed answer than we can about what prospects there are for benefit from treatment.

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