Shoulder Pain - Back to Health Chiropractors

Shoulder Pain

Shoulder Pain and Chiropractic

The shoulder is in itself a marvel of mechanical engineering. Of all the joints in the body it has the greatest degree of motion. It is precisely because of its tremendous flexibility that the shoulder joint can be vulnerable to injury. This information is to help you understand:

The anatomy of the shoulder joint
How the shoulder works
The common conditions that affect the shoulder

The Anatomy of the Shoulder Joint

The shoulder is of course made up of a number of different structures including:

Muscles: The main muscles in the shoulder are the 4 rotator cuff muscles including

Supraspinatus muscle which lifts the arm
Infraspinatus muscle which externally rotates the arm
Teres Minor which also externally rotates the arm
Subscapularis muscle which internally rotates the arm. These muscles are charged with providing movement to the arm and shoulder

Ligaments and tendons: A ligament connects bone together with other bones and there are some important ligaments around the shoulder joint. Tendons connects muscles to bone. The shoulder joint also has a joint capsule which encapsulates the joint and is filled with synovial fluid to help the joint move and protects it from becoming dislocated.
Nerves: There is a large bundle of nerves that travel underneath the shoulder joint in the armpit. These nerves are called the Radial nerve, the Median nerve and the Ulnar nerve. They transmit signals from the brain to the muscles telling them how to contract and sensations from the hand to the brain such as touch and temperature.
Blood vessels: Running alongside the nerves in the underarm is the very large Axillary artery which continues down into the arm and serves as the main blood supply to the arm and hand.
Bones and joints: The bones of the shoulder include the

Humerus which is the bone in the upper arm
Scapula which is commonly called the shoulder blade
Clavicle which is also known as the collar bone

Joints: There are in fact 4 joints that make up the shoulder including:

The Glenohumeral joint
The Acromioclavicular joint
The Sternoclavicular joint
The Scapulothoracic joint

Bursae: Within the shoulder joint there are a number of smaller fluid filled sacs that serve to reduce friction and enhance mobility within the joint. Bursae are found throughout the body wherever two body parts rub against each other and is used to reduce friction.

The shoulder joint is often described as a golf ball sitting on a golf tee. There are many different types of injuries that can affect the shoulder region. Some of the most common injuries we see as chiropractors are:

Frozen shoulder (Adhesive Capsulitis)
Strain of the rotator cuff muscles

If you suffer with shoulder pain and would like to find out how a chiropractor can help you then call 0207 000 1728 to make an appointment now. Shoulder Pain Frozen Shoulder Xray

What is a Frozen Shoulder?

Frozen Shoulder is commonly known as an Adhesive Capsulitis. It can be an extremely painful condition often associated with a loss of range of movement in the shoulder joint. Patients often describe an inability to lift their arm up over their head and in severe cases unable to lift it from their side. Sleeping can be a problem as pain can often wake the patient at night, especially as they roll over and change position. Frozen shoulder is a general term used to describe a significant and marked reduction in the overall range of motion in the shoulder joint. Clinically this is known as Adhesive Capsulitis. There is a whole spectrum of how severe the adhesions are or how frozen the shoulder is from mild through to very severe:

Mild inflammation and irritation to the shoulder joint capsule resulting in no capsular very limited loss of range of motion but painful movements of the shoulder particularly in abduction.
Mild adhesions in the shoulder joint results in reduced range of motion as well as pain that is more intense and more constant.
Moderate size adhesions in the joint. The pain is slightly less severe than type 2 but the restriction in range of motion is more marked. There may be no pain at rest but significant pain and stiffness on movement.
Mature and chronic adhesions with extreme loss of range of motion particularly in flexion, abduction and external rotation

Causes of Shoulder Pain (Frozen Shoulder)

Sometimes the condition comes on with no specific trauma or injury and the cause remains unknown which is termed idiopathic. This condition can last from months to three years or more and is thought in some cases to be caused by injury or trauma to the area. It is believed that it may also have an autoimmune component, with the body attacking healthy tissue in the capsule.
There are a number of risk factors that may predispose a person to frozen shoulder including:

Trauma to the shoulder
Prolonged bad posture
Repetitive movements of the shoulder
Prolonged immobilisation
Chronic injury to the shoulder including tendonitis
Diabetes, stroke victims, connective tissue disorders, lung disease, and heart disease are potential risk factors for developing frozen shoulder

Signs and Symptoms of Shoulder Pain (Frozen Shoulder)

Pain and stiffness in the shoulder region are often the first signs and symptoms to become apparent. The early signs and symptoms need to be differentiated from a simple tendonitis. Getting help quickly is extremely important as early intervention encourages a good result and hopefully prevents the condition from progressing to more severe and chronic conditions. Often patients with a frozen shoulder will have difficulty with simple everyday tasks such as lifting, washing up and putting on clothes. Sleeping is commonly a problem. Patients often wake up in pain as they move throughout the night.

Examination and Assessment of Shoulder Pain (Frozen Shoulder)

Your Back to Health Chiropractor will conduct a thorough history of what exactly has caused the injury This will include questions on:

The exact location of the pain
Exacerbating and relieving factors
Causes
Types of pain
Referral of pain
Family history etc

You will then be offered an in depth physical examination which will look at:

General posture and flexibility
Palpation may reveal muscle tenderness and tightness in the shoulder region and rotator cuff muscles
There may be reduced active and passive range of motion
Orthopedic tests may be positive including painful arc test
Muscle tests to determine the extent of weakness
Neurological assessment if required
X-rays of the shoulder and spine may be conducted depending on the extent of your problems and the examination findings

Your Back to Health Chiropractor will discuss with you exactly what examinations will be appropriate and will require your consent before undertaking an examination. Once a diagnosis has been confirmed then specific treatment options can be discussed. Chiropractor Xray Assessment

Chiropractic Treatment for Shoulder Pain (Frozen Shoulder)

The primary mode of intervention for a frozen shoulder is to adjust the shoulder and often the spine if there is involvement of areas other than the shoulder. The adjustment is a gentle manual procedure to improve joint mobility and flexibility as well as reducing pain and inflammation. Initially the adjustments will be a gentle mobilisation.
In the early stages of frozen shoulder after an injury. Ice may be used as well. As the condition becomes more chronic then heat will be used more often than not.
Stretches and exercises to improve joint range of motion and rehabilitate muscles that are weakened and wasted (atrophied).
More physical adjustments can be conducted as the inflammation in the shoulder reduces.
Your Back to Health Chiropractor will be assessing and treating where necessary any underlying postural abnormalities that are contributing to the condition. It is essential to address the cause of the frozen shoulder as well as treating the symptoms.

It is important to be patient with your care as it can take weeks and months of treatment to improve. Once the patient has returned to a pre injury status of health it important to maintain your health and prevent a recurrence of your injury. Your Back to Health Chiropractor will be able to advise you as to the very best way to stay on top of your shoulder problems in future.

If you suffer with shoulder pain and would like to find out how a chiropractor can help you then call 0207 000 1728 to make an appointment now.