The shoulder joint is an extremely complex design that must provide large mobility. Unfortunately due to this the shoulder lacks stability and is therefore vulnerable to injury. Many people aren’t aware that Chiropractors are in fact skilled in an array of peripheral joint techniques meaning they’re well placed to assist with shoulder pain and problems. Here we explore many of the most common shoulder pain issues as well as typical techniques that Chiropractors may use to assist in your recovery.

Anatomy Of The Shoulder

The shoulder joint is made up of the humerus (arm bone) which articulates with the scapula (shoulder blade). Other important bony structures of the shoulder girdle include the acromion, clavicle and coracoid process which are all closely linked with muscular and soft tissue attachments. Surrounding these bony structures are the fluid-filled spaces called bursa, labrum cartilage and rotator cuff muscles and tendons. The major function of these structures is to work in unison to provide mobility so we’re able to grasp objects and deflect harm in all areas around our body.

Common Shoulder Pain Injuries

Shoulder problems are associated shoulder pain is quite a common clinical presentation in a Chiropractic clinic. Some of the major problems include:

  • Referred pain from the cervical and thoracic spine. Joints, muscles and other pain producing structures like nerves and discs can refer discomfort in and around the shoulders which may mimic a shoulder problem
  • Bursitis is a rather painful complaint that doesn’t only affect the shoulder. Essentially bursitis is inflammation of the bursa sac which can refer a moderate to severe ache throughout the shoulder girdle. Typical management include rest, ice, anti-inflammatory medication and soft tissue massage
  • Tendonitis is a common problem given the amount of activity our shoulders perform on a daily basis. There are various tendons attaching to and around the shoulder, most commonly tendonitis will occur in the rotator cuff tendons. Management for tendonitis is very similar to that of bursitis
  • Shoulder impingement syndrome typically presents in individuals with poor posture or older persons. This problem leads to an inability to raise the arm above the head due to compression of the subacromial space
  • Frozen shoulder (also referred to as adhesive capsulitis) contributes to losses in normal movement and strength. Frozen shoulder is quite often poorly diagnosed due to its fluctuating nature and limited demonstration on imaging such as x-ray, MRI and CT
  • Calcific tendonitis leads to deposits of calcium in the shoulder tendons which contributes to significant pain and loss of mobility
  • Shoulder dislocation is quite a common injury. The most unstable position is with your arm directly above your head and even a minor blow which forces your arm backwards can lead to a shoulder dislocation
  • ACJ ligament tears lead to a weakness and seperation of the acrio-clavicular joint. Typically individuals who have suffered this injury have what is referred to as a ‘step defect’ on the superior aspect of the clavicle
  • Biceps tendon pathology can lead to significant anterior shoulder pain and upper arm disability. Associated symptoms may also include biceps weakness
  • Rotator cuff tears can occur during varying degrees of movement and lead to loss of normal shoulder strength

Signs That You Should Seek Treatment For Your Complaint

  • If your shoulder pain has been present for numerous days
  • If there are no signs your problem is resolving
  • If you have a history of recurring shoulder problems
  • If you notice significant pain, loss of movement, weakness, numbness and tingling
  • If your shoulder pain is present during rest/no activity
  • If you demonstrate signs of infection which include elevated temperature, swelling, redness, heat and fever

Chiropractic Treatment Of Shoulder Problems

Sports Chiropractors are particularly well equipped with treatment techniques suitable for shoulder problems and rehabilitation. The first goal is to establish what the exact problem is as this will direct appropriate management. Your Chiropractor will need to perform a clinical assessment of your neck, shoulder girdle and thoracic spine which typically involves palpation, muscle testing, orthopaedic and neurological tests. If further imaging is required to ascertain additional information than your Chiropractor can discuss this with you and appropriately refer you to your chosen physician.

Treatment to expect with a Chiropractor may include:

  • Shoulder manipulation and mobilisation to improve joint function, reduce muscle tension, assist with pain and enhance healing
  • Soft tissue massage to structures including muscles, tendons and ligaments
  • Ice/heat to assist with pain and inflammation
  • Home exercise advice to promote flexibility, regain strength and therefore return to normal activities
  • Physiological therapeutics such as laser, ultrasound and TENS are also extremely effective for managing shoulder pain

If conservative management does not resolve your problem other options include:

  • Cortisone injection
  • Anti-inflammatory medication
  • Surgery