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Shoulder Pain

What causes shoulder pain?

Other than acute injuries, shoulder pain is often caused by overuse. Some common conditions are:

  • Sprain and strain
  • Impingement syndrome
  • Rotator cuff tendonitis
  • Adhesive Capsulitis (Frozen Shoulder)

The shoulder joint is part of a complex mechanical unit comprising of the neck, the scapula, and the shoulder girdle. Like the hip, it is a ball-and-socket joint, but has a high degree of flexibility. Its stability depends on the surrounding musculature, namely the rotator cuff muscles. The shoulder joint connects the arm to the torso, and is a crucial link in the kinematic chain of arm movements. Sometimes, problems originating from the neck can also produce pain in the shoulder or arm, and vice versa. Careful examination is therefore necessary to determine the cause of shoulder pain before treatment is implemented.

One common condition of the shoulder is Adhesive Capsulitis.  It usually occurs in middle age, especially in females around the 5th-6th decades, and is caused by chronic shoulder injury or strain due to poor posture, in addition to changes in hormones, leading to inflammation of synovial fluid inside the glenohumeral joint capsule.  Besides pain, it is associated with severe limitations in the ranges of motion of the shoulder joint, especially in abduction and external rotation.  For this reason, Adhesive Capsulitis is also known as "Frozen Shoulder", with the "Frozen" state lasting up to 2 years in natural history.  The treatment approach of Adhesive Capsulitis is to relieve the symptom of pain and muscle contraction, and to gradually improve all shoulder ranges of motion.  Your chiropractor may also perform assessment and manipulation on the spinal joints to correct any faulty postures to reduce mechanical strains to the shoulder joint.

What is the chiropractic treatment approach for shoulder pain?

  1. Reduce Pain - The goal of treatment initially would be to reduce the pain, or to “break the pain cycle”. As the pain level is reduced, the muscles will relax, reversing the pain cycle. Certain modalities, such as dry-needling, ultrasound therapy and interferential current therapy, may be employed to provide pain relief, reduce inflammation and promote muscle relaxation.  
  2. Restore normal joint mechanics - Depending on the examination findings, your chiropractor may adjust (manipulate) the joints that are misaligned (subluxated). Shockwave therapy will also facilitate healing of the soft tissues surrounding the shoulder joint.
  3. Improve flexibility and strength – To prevent future injuries, it is important to improve the flexibility of the joints and the strength of the muscles. Your chiropractor will advise you on appropriate stretching and strengthening exercises according to your physical needs and fitness level.
  4. Lifestyle adjustments – Exercises, working posture, sleep etc. play a vital role in the development and otherwise prevention of shoulder pain. Your doctor will work with you to identify lifestyle adjustments that will help you maximize the quality of your health.

How effective is chiropractic for shoulder pain?

The neck, shoulder, elbow and wrist joints act as a chain in many upper limb movements. A critical factor in recovering from shoulder pain is promoting/enabling movement of the above joints. Chiropractic treatments such as manipulations, dry-needling and electrotherapy help to restore the proper joint mechanics, increase blood flow, reduce pain and relax muscles. In doing so, chiropractic care enables the shoulder joint to begin moving freely, while reducing or alleviating pain.

What are the Recommended Treatments for Shoulder Pain?*

Author: Dr Claudia Ng, BSc, DC

* A proper diagnosis has to be obtained for all of the above conditions before an appropriate combination of treatments will be provided. This is just a list of possible treatments for the individual condition but not all of them may be necessary, nor is it limited to those listed only.

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