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

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.