Acupoint Embedding Combined with Radial Extracorporeal Shock Wave Therapy Versus Conventional Pharmacotherapy for Poststroke Shoulder–Hand Syndrome: A Retrospective Cohort Study on Pain,Motor Recovery,and Inflammatory Biomarkers

Abstract

Background

Shoulder–hand syndrome (SHS) is a common and difficult-to-treat complication after stroke, with conventional drug therapy often providing only short-term relief.

Objective

This study aimed to compare the efficacy of acupoint embedding therapy combined with radial extracorporeal shock-wave therapy (rESWT) versus standard drugs for poststroke SHS.

Methods

A total of 104 patients with stage I poststroke SHS were divided into a combination group (n = 55, receiving acupoint embedding and rESWT for 4 weeks) and a control group (n = 49, receiving conventional drug therapy). Outcomes measured included pain (VAS), upper limb motor function [Fugl–Meyer Assessment-Upper Extremity (FMA-UE)], daily living ability (modified Barthel index), hand swelling, surface electromyography (sEMG) parameters, shoulder passive range of motion (PROM), and serum inflammatory factors (TNF-α, IL-6).

Results

After 4 weeks, the combination group was associated with significantly greater improvement than the control group in all measured outcomes (all P < .05), including pain relief, functional recovery, reduced swelling, better shoulder PROM, improved muscle activation, and lower inflammatory markers. The combination group also had a higher total clinical effective rate (89.09% vs. 79.59%, P = .036) and a lower incidence of adverse events (14.55% vs. 34.69%, P = .016).

Conclusion

For poststroke SHS, the combination of acupoint embedding and rESWT was associated with greater improvements than conventional drug therapy, providing superior pain relief, functional recovery, and anti-inflammatory effects, with a better safety profile.