Abstract
Background
Shoulder impingement syndrome (SIS) is a leading cause of shoulder pain and frequently results in persistent pain and functional impairment despite conservative management. Evidence supporting thread-embedding acupuncture (TEA) for SIS remains limited. This evidence-based case report evaluated the clinical applicability of TEA in persistent SIS.
Case
: A 30-year-old woman presented with a 3-month history of right shoulder pain following repetitive overhead activity during yoga. Positive Neer, Hawkins–Kennedy, and Jobe tests and radiographic subacromial narrowing supported the diagnosis of SIS.
Methods
A focused clinical question was formulated using the population, intervention, comparison, and outcome framework. PubMed, Scopus, and ScienceDirect were searched for systematic reviews, meta-analyses, and randomized controlled trials published up to 2026. Eligible studies were critically appraised for validity, clinical importance, and applicability before integration with patient characteristics and clinical expertise.
Results
Two comparative studies provided directly applicable evidence suggesting that TEA may be a safe adjunctive intervention, although evidence certainty was low to moderate. Following TEA, the Shoulder Pain and Disability Index (SPADI) improved from 30.8% at baseline to 5.4% at 1 month, while visual analog scale (VAS) pain decreased from 5 to 0, and shoulder abduction improved from 87° to 180°. Mild symptom recurrence occurred at 3 months (SPADI 16.9%, VAS 3), although outcomes remained improved from baseline. No significant adverse events were reported.
Conclusion
TEA may be considered a complementary treatment for persistent SIS. Favorable short-term recovery was observed, while larger randomized controlled trials are needed to establish long-term effectiveness and standardized treatment protocols.