Anatomically-Guided Electroacupuncture Combined With Cupping for Shoulder Pain

University of Medicine and Pharmacy at Ho Chi Minh City70 enrolled

Overview

This study compares two acupuncture-based treatments for shoulder pain. Adults with shoulder pain will be randomly assigned to one of two groups. One group will receive electroacupuncture at points chosen based on the anatomy of the painful muscle, combined with moving cupping therapy. The other group will receive electroacupuncture using a standard set of traditional acupuncture points. Both groups will receive daily treatment for 5 days. The main question is whether the combined treatment reduces pain and improves shoulder function more than standard electroacupuncture, measured using a shoulder pain and disability questionnaire completed before treatment and after each session.

This is a single-center, prospective, randomized controlled trial conducted at the Traditional Medicine Unit, Thong Nhat Hospital, Ho Chi Minh City, Vietnam, from December 2025 to March 2026. Seventy adults over 18 years of age diagnosed with mechanical shoulder pain (ICD-10 M75.0-M75.9) were assigned in a 1:1 ratio, using block randomization with sealed envelopes (block size of 10), to an intervention group (n=35) or a control group (n=35). The intervention group received moving cupping therapy over the upper back and shoulder region for 10-15 minutes every other day (3 sessions total), followed by electroacupuncture at points selected according to the anatomical location of the affected muscle layer and the movement that provoked pain, applied at 60-100 Hz for 20 minutes once daily for 5 consecutive days. The control group received electroacupuncture using a standard set of classical acupuncture points at the same frequency, duration, and treatment schedule, without cupping. The primary outcome is change in the Shoulder Pain and Disability Index (SPADI), which includes a pain subscale (5 items) and a disability subscale (8 items), assessed at baseline and after each of the 5 treatment sessions. Adverse events were monitored throughout the treatment period. Statistical analysis followed the intention-to-treat principle, using repeated-measures analysis of variance and linear mixed models to compare score trajectories between groups over time, adjusted for age, sex, and body mass index.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

Interventions

Anatomically-guided electroacupuncturePROCEDURE

Electroacupuncture using filiform needles inserted at ashi points (tender points) selected according to the anatomical location of the affected shoulder muscle and the movement provoking pain (e.g., SI9, SI11, TE14, LI15, GB21, BL17). Needles were stimulated electrically at 60-100 Hz and retained for 20 minutes, once daily for 5 consecutive days.

Moving cupping therapyPROCEDURE

Moving cupping therapy applied over the upper back and shoulder region. Paraffin oil was applied to the skin, and a plastic cup (3-5 cm diameter) was moved along both sides of the thoracic spine, passing over the supraspinous and infraspinous fossae, using intermittent lifting to avoid localized bruising. Total duration 10-15 minutes per session, performed every other day for 3 sessions.

Classical electroacupuncturePROCEDURE

Electroacupuncture using filiform needles inserted at a standard set of classical acupuncture points following the protocol of the Vietnam Ministry of Health, including local points SI15, SI14, BL11, GB21, TE14, LI15, LI14, SI9, and SI11, plus distal points LI11, LI10, TE5, and LI4. Needles were stimulated electrically at 60-100 Hz, retained for 20 minutes, once daily for 5 consecutive days.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults over 18 years of age * Diagnosed with shoulder pain according to ICD-10 codes M75.0-M75.9 * No infectious or malignant disease of the shoulder * Willing to provide informed consent to participate Exclusion Criteria: * Complete rotator cuff tear on imaging requiring surgical intervention * Currently receiving systemic corticosteroid therapy * Concurrently receiving acupuncture treatment at another facility * Contraindication to electroacupuncture or cupping therapy, including coagulation disorders, skin infection at the treatment site, or cardiac pacemaker

Outcomes

Primary Outcomes

Change in Shoulder Pain and Disability Index (SPADI) Pain Subscale Score

The SPADI pain subscale consists of 5 items, each scored 0-10, for a total raw score of 0-50, transformed to a 0-100 scale. Higher scores indicate greater pain severity. Assessed by patient self-report before treatment and after each of 5 daily treatment sessions.

Time frame: Baseline (T0), Day 1 (T1), Day 2 (T2), Day 3 (T3), Day 4 (T4), and Day 5 (T5)

Change in Shoulder Pain and Disability Index (SPADI) Disability Subscale Score

The SPADI disability subscale consists of 8 items assessing activities of daily living, each scored 0-10, for a total raw score of 0-80, transformed to a 0-100 scale. Higher scores indicate greater functional limitation. Assessed by patient self-report before treatment and after each of 5 daily treatment sessions.