Syed Raza R. Husain, DO
Resident Physician
Rutgers NJMS/Kessler Institute for Rehabilitation
Morganville, New Jersey, United States
Slawomir Sender, MD
Attending Physician
East Orange VA/Rutgers NJMS
East Orange, New Jersey, United States
A 64-year-old African-American male (C5 AIS D) was admitted to the spinal cord injury disorders program at East Orange VA Medical Center. Six months earlier, he had sustained an SCI due to progressive cervical myelopathy and underwent spinal decompression and fusion. At discharge, the veteran had intact bilateral upper extremity movement but was dependent for all ADLs and mobility due to weakness, neuropathic pain, and chronic osteoarthritis in both shoulders. Neuropathic pain was well controlled, but joint pain worsened over time, leading to positional intolerance for bowel care, transfers, and pressure relief. This resulted in a sacral pressure injury and hindered functional progress.
Discussions: On admission, the veteran reported 10/10 bilateral shoulder pain. Initial pain management using lidocaine, anti-inflammatories, opiates, and corticosteroid injections provided minimal relief. He then consented to acupuncture for pain control. After the first session to the left shoulder, his pain reduced to 6/10. A second session to the right shoulder further decreased pain to 4/10. This relief lasted two weeks before symptoms gradually returned.
Conclusions: The veteran’s pain improvements led to better tolerance of bowel and wound care, physical therapy, and occupational therapy. Increased shoulder range of motion allowed him to transition from dependent to independent feeding. Enhanced pain control also enabled Hoyer transfers, and he eventually achieved independent mobility with a power wheelchair. Chronic orthopedic pain in SCI patients can significantly impact functional outcomes. This case demonstrates that acupuncture can be an effective adjunct therapy within a comprehensive pain management program.
