Shoulder pain can be produced from different tissues, such as rotator cuff muscles (chart 1-4), capsule (chart 5, frozen shoulder or adhesive capsulitis), bursitis (chart 6), biceps, deltoid muscle, degenerative joint diseases, et al. Pain medicine can be good choice for some shoulder pain patients, but long term use of opiate is not good choice because misuse of opiate causes death and has become a national crisis as announced by US president in 2017; repetitive injection of steroid is not good choice, either, because many patients get worse eventually even if they got better firstly.

Among the patients who are not good candidates for surgery, combination of physical therapy and acupuncture may be the best choice. Counter Stimulation Therapy is an integrative approach for the management for shoulder pain, better than physical therapy alone or acupuncture alone. Counter Stimulation Therapy can reduce pain faster, promote the healing faster, strengthening the muscle and restore function faster.

While manage with Counter Stimulation Therapy, not only the shoulder is evaluated, any shoulder pain associated structures will be evaluated. As a result, many associated tender points (not only in shoulder area) or trigger points will be founded (theses are generally missed by most doctors). These associated tender of trigger points are very important in reducing pain and promoted healing.

During the first visit, patient will expect about one-hour evaluation and treatment. The associated tender points and trigger points will be found, and trier treatment with be delivered. A majority of patient will experience relieve of pain, and then a detailed plane of care will be discussed with patient.

Adherent to the plan of care is essential to the best outcome.