OBJECTIVE: To explore the therapeutic effects of needle warming moxibustion (NWM) combined with trigger point massage on shoulder function and stress responses in elderly patients with frozen shoulder (FS), providing clinical guidance. METHODS: A retrospective analysis was conducted on 116 patients with FS treated at the Guangdong Work Injury Rehabilitation Hospital from October 2022 to October 2023. The study included 61 patients who received NWM combined with trigger point massage (research group) and 55 patients who received conventional treatment (control group). Shoulder function and pain were assessed using the Constant-Murley Score (CMS) and the Short-Form McGill Pain Questionnaire (SF-MPQ). Additionally, the time to resume normal daily activities, time to achieve no self-perceived pain, and adverse reactions were documented. Post-treatment stress response indicators and inflammatory factors; adrenaline (ADR), cortisol (Cor), adrenocorticotropic hormone (ACTH), C-reactive protein (CRP), nitric oxide (NO), and prostaglandin E2 (PGE2), were measured. A 3-month follow-up was conducted to record prognostic recurrence. RESULTS: After treatment, the research group showed significantly better shoulder function, reduced pain, and shorter times to resume daily activities and to achieve no self-perceived pain compared to the control group (all P<0.05). Post-treatment levels of ADR, Cor, ACTH, CRP, NO, and PGE2 were also lower in the research group (all P<0.05). The incidence of adverse reactions did not significantly differ between groups (P>0.05); however, the recurrence rate was lower in the research group compared with the control group (P<0.05). CONCLUSIONS: NWM combined with trigger point massage effectively improves shoulder function and reduces inflammation and stress responses in elderly patients with FS, supporting its clinical application.