“I cannot lift my arm and at night it is worse.”
I cannot lift my arm
Four months of a stiff shoulder in someone who earns a living with her arm above her head.
- Patient
- Woman, 56
- Occupation
- House painter; thirty years with her arm overhead
- Medication
- Ibuprofen when she cannot bear it. Nothing prescribed.
- History
- X-ray four months ago: mild arthrosis, no tear.
- Habits
- Sleeps on her right side to keep off the bad shoulder.
- Vitals
- BP 130/80 · afebrile
1 · The consultation
You have 18 minutes. Each question or examination costs 2. Choose carefully what to ask.
Questions
Examination
2 · The tongue
3 · The pulse
Describe the pulse on each axis.
4 · The pattern
5 · Differential diagnosis
You're torn between two patterns. Which is it?
Which finding decides it?
6 · Case twist
Before finishing“«My hand is perfectly fine: normal strength, no tingling. And I have not fallen or knocked it. The only thing is I have not been able to paint ceilings for four months.»”
Mark the warning signs present:
What do you do?
7 · The treatment
Principle
Strategy
Points (choose 5)
Case solved
Reasoned solution
Pattern: Blood stasis in the shoulder. Supporting signs: Fixed pain, always the same point, Worse at night, stabbing, Refuses pressure, Purple tongue with dark veins, Choppy pulse.
The deciding clue: Always the same point: She points to one spot with a finger and it never moves. Wind Bi travels..
Safety: A shoulder stiff for months, with no trauma, no neurological deficit and no hot joint: move the Blood and free the channel.
Treatment: Move Blood at the point, Free the channel; Local points plus one distal. Points: LI15, TE14, SI9, LI4, SP10.
More patients are waiting in the app, with voice, a real timer and a history of your decisions.
See the solution without playing
Pattern: Blood stasis in the shoulder. Supporting signs: Fixed pain, always the same point, Worse at night, stabbing, Refuses pressure, Purple tongue with dark veins, Choppy pulse.
The deciding clue: Always the same point: She points to one spot with a finger and it never moves. Wind Bi travels..
Safety: A shoulder stiff for months, with no trauma, no neurological deficit and no hot joint: move the Blood and free the channel.
Treatment: Move Blood at the point, Free the channel; Local points plus one distal. Points: LI15, TE14, SI9, LI4, SP10.
Teaching case. Fictional patient for study purposes. If you have real symptoms, consult a healthcare professional.
