A Case Report on Pain and Functional Recovery in a Post-Stroke Shoulder Pain Patient Treated with Korean medicine Centered on Acupotomy

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J Korean Med. 2025;46(3):168-181

Publication date (electronic) : 2025 September 1

doi : https://doi.org/10.13048/jkm.25042

Hyonjun Chun ¹^,²^,^§

, Teh-Cheng Sun ²^,³^,^§

, Yu-bin Kim ⁴

, Chang-ho Han ⁵

, Mikyung Kim ⁶^,

¹Department of Korean Medicine, The 8th Maneuver Division

²Korean Medical Society of Acupotomology, Seoul

³Department of Korean Medicine, Bareun-Jisung Korean Medicine Hospital

⁴Department of Internal Korean Medicine, Dong-Shin Korean Medicine Hospital

⁵Department of Internal Medicine, College of Korean Medicine, Dongguk University WISE Campus, Gyeongju-si

⁶Department of Internal Medicine, Dongguk University Ilsan Oriental Hospital, Goyang-si

Correspondence to: Mikyung Kim, Dongguk University Ilsan Oriental Hospital, 27, Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Korea, Tel: +82-31-961-9045, FAX: +82-31-961-9009, E-mail: 01mkkim@gmail.com

^§

These authors contributed equally to this work.

Received 2025 June 18; Revised 2025 July 24; Accepted 2025 August 12.

Abstract

Background

Post-stroke shoulder pain (PSSP) is a common complication that impedes upper limb function and quality of life. This case report describes the clinical outcome of Korean Medicine (KM) treatment centered on acupotomy in a patient unresponsive to conventional therapies.

Case Presentation

A 67-year-old woman developed severe right shoulder pain and upper limb dysfunction following a left basal ganglia infarction. PSSP was attributed to repetitive load-bearing during walker-assisted ambulation. Conservative treatments including acupuncture, electroacupuncture, cupping, and physical therapy were ineffective. She underwent 17 outpatient sessions over 60 days with KM centered on acupotomy. Acupotomy was performed at sites of muscle tension and tenderness (10–30 mm depth). Acupuncture was applied to bilateral LI4, LI11, TE5, ST36, GB34, LR3, and tender points in the right deltoid. Electroacupuncture (3 Hz, 10 minutes) was applied to the deltoid, and cupping was also administered.

Results

The patient exhibited marked clinical improvements: Numeric Rating Scale (NRS) score decreased from 10 to 3, and Shoulder Pain and Disability Index (SPADI) score improved from 121 to 28. Quality of life (QoL) also improved: EuroQoL-5 Dimension Visual Analogue Scale (VAS) increased from 30 to 80, and Stroke-Specific QoL score rose from 135 to 178. No serious adverse events occurred.

Conclusion

KM centered on acupotomy, even without conventional rehabilitation, may be an effective therapeutic strategy for subacute PSSP unresponsive to standard care. Further controlled trials are warranted to validate its efficacy and mechanisms.

Keywords: post-stroke shoulder pain; acupotomy; Korean medicine; cerebral infarction; rehabilitation

Fig. 1

Brain MRI

Fig. 2

Timeline of treatments and evaluations

Fig. 3

Acupotomyused in this study (0.6 mm diameter, 50 mm length)

Fig. 4

Marked insertion sites for acupotomy(A) lateral decubitus position, used for deltoid, levatorscapulae, and posterior cervical muscles (B) supine position, used for medial epicondylar region.

Fig. 5

Progression of Quality of life(SS-QoL, EQ-5D VAS) with treatment

Fig. 6

Progression of Numeric Rating Scale (NRS) with treatment

Fig. 7

Progression of Shoulder Pain and Disability (SPADI) scores with treatment

Table 1

Changes in Quality of Life (SS-QoL, EQ-5D VAS) and Pain (NRS, SPADI) Scores over the 60-Day Treatment Period

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