Keywords; frozen shoulder exercises, acromioclavicular joint, rotator cuff syndrome, arm pain treatments, chiropractic help )
This is probably one of the most painful and debilitating conditions faced
in the chiropractic clinic. What's more it remains extremely painful,
and disabling, for a long time if not properly managed. Up to
three years and longer.
Simple daily activities like taking off a t-shirt or putting on a coat, even combing one's hair become an ordeal. Sleep is invariably disturbed, which is why it gets such a high quick dash rating; see lower down.
Prevention is the key! Nip the pain in the bud before your shoulder turns to ice.
Shoulder pain is caused by many conditions. The majority, but not all, are the result of irritation of nerves in the lower neck or upper thoracic spine. That is why chiropractic treats shoulder pain so successfully.
It is one of the more difficult conditions causing shoulder pain. It can be successfully treated with chiropractic, however the shrunken shoulder capsule, depending on how advanced the shoulder pain is, may take several months and very occasionally a whole year to resolve, even with chiropractic.
Medically, the condition is acknowledged to take up to three years to resolve.
And understanding of shoulder anatomy will help you grasp the complexity of this painful condition.
To give the arm the large range of motion it enjoys, the socket is shallow and there are four complex joints to give the shoulder stability. To understand why this joint gives such trouble some understanding of the shoulder anatomy will be instructive.
To deepen the socket there is a labrum which is often involved in the impingement syndromes. For example, a fall on the outstretched arm may tear the labrum. It can only be diagnosed on an mri or ultrasound scan.
See another photo of the man above at the bottom of this page.
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What is a Frozen Shoulder? FS
Adhesive capsulitis, it's medical name, is a condition that causes substantial loss of movement in the
shoulder joint. The joint capsule becomes shortened and tight, and
adheres to the bone, hence the complete medical name for frozen shoulder
is an adhesive capsulitis.
It is one of the most painful conditions treated in chiropractic clinics. Prevention is the word, but it can develop with frightening rapidity.
Arm pain treatments at the chiropractic coalface always begin with a search for irritation of the nerves from the lower neck to the muscles, tendons, ligaments or capsule is usually, but not always, central to this condition.
A diagnosis of adhesive capsulitis is often used for any painful shoulder condition associated with a loss of motion which is not strictly true.
The pain and disability in frozen shoulder are often extreme. Any and all movements of the upper arm, particularly internal rotation, become severely limited. Chiropractic treats the frigid capsule particularly successfully, but it remains a nuggety problem. There simply is no quick fix.
Often the cause lies elsewhere so the cervical spine, the first rib and the acromio clavicular joint must all be carefully examined.
The triceps muscle in the upper arm, and the subscapularis muscle beneath the shoulder blade are often involved.
A fine emulsion of calcium is sometimes deposited in the glenohumeral joint; it's called toothpaste shoulder for obvious reasons.
What Are The Symptoms Of Frozen Shoulder?
FS is characterized by a extreme loss of shoulder motion. Raising the arm, both forwards and sideways, and turning it inwards becomes very limited and extremely painful. Thus taking off a t shirt and particularly putting on a coat may cause extreme pain. Reaching the bra hook behind the back is quite impossible.
It is most common in the middle years around 40 to 50 and is twice as common in women as men.
This condition begins with just a little irritation in the shoulder, but rapidly enters the acute phase, characterised by extreme pain, sleep disturbance and functional impairment; you can't brush your teeth, get a cup out of the cupboard or clean the bath. Because chiropractic addresses function, it is able to treat frozen shoulder particularly well.
This is followed by a progressive stiffening phase as the shoulder motion worsens, particularly internal rotation, and raising the arm above the head. Extreme disability is common, with even simple everyday activities such as brushing the hair, dressing, and household work causing extreme shoulder pain. This phase may last several years if not properly treated.
The final phase, inadequately treated, often only begins after a year or two, with a mountain of frustration first to be experienced, is the resolution or thawing phase identified by the gradual return of both motion and function.
The overall course is variable but can last 12 to 36 months.
Any and all conditions of the human body are affected by a defective blood circulatory system and that includes FS. Insufficient oxygen means that tissues can't heal. Pathophysiology of atherosclerosis; hardening of the arteries explained in layman's terms.
While these common causes of frozen shoulder may seem quite different, they all result in one or more of the following:
All of the above may lead to inflammation in the shoulder joint capsule. This capsule includes the ligaments that attach the shoulder bones to each other.
"Frozen shoulder is very poorly diagnosed and managed."
Dr David Connell, a consultant in radiology at the Royal National Orthopaedic Hospital in Stanmore.
When inflammation occurs within the capsule, there is less
ability for the shoulder bones to move freely within the joints (there
are four shoulder joints). For this reason a frozen shoulder is also
called an adhesive (scarred) capsulitis (inflamed joint capsule).
Ribs pertain correctly to the thoracic spine but
very occasionally a cervical rib may affect the nerve and blood supply
to the arm causing amongst other things frozen shoulder. Usually the
ribs are small and of little clinical significance, but every now and
then there's a giant.
How is Frozen Shoulder treated?
Chiropractic Help treatment is directed at four domains:
Surgery should be avoided except in the most extreme cases. Steroid
injections may help but there is risk of infection and tendon rupture.
However manipulation under anaesthetic in extreme cases can have
For more information about the dangers of anaesthetics: ANAESTHETIC ALZHEIMERS.
Sleeping on the non-painful shoulder, with a pillow placed in front of the body for the painful arm, is advisable.
It took about four months before Mr S's shoulder settled down, and he admits himself that it only stabilised once he decided to do the exercises faithfully, continuing after the pain had nearly ceased. Four months and ten treatments.
A word of advice: if the FS has become chronic, the chiropractic regime of increased movement may initially cause increased pain. Don't be dismayed, just do the stretches more gently, more carefully, and perhaps fewer repetitions. Ironically, do more icing, followed by moist heat. Be patient! It will get better with chiropractic care. This is certainly one condition where the saying, Rome wasn't built in a day, applies.
Treatment of the neck alone is not adequate. If your chiropractor is not treating the shoulder itself, talk to him. Perhaps consider a change to a sports-oriented chiropractor.
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Then perhaps you're ready for a Personal Medical insurance plan. You'll save a mint. But one serious car accident, breast cancer.... it can all go horribly wrong. Personal medical insurance is a very personal decision.
I'm uninsured....! I believe in personal medical insurance. But then I'm 100% committed to following a healthy lifestyle. Are you?
Even a nasty frozen shoulder shouldn't cost you more than 10-15 chiropractic treatments. Perhaps a lot less.
FROZEN SHOULDER TREATMENTS
- a systematic review of the literature
Literature reviews find there is no place for anti inflammatories in the treatment of FS. Vigorous mobilization of the joint, active and passive exercises reaching but not exceeding the pain threshold, deep muscle treatment and a invasive therapy known as hydrodilatation all appear to have some but limited benefit.
There is no research showing that chiropractic treatment helps (that I know of any way), yet it is one of the favourite conditions that I like to treat. But... Rome wasn't built in a day, nor is a chronic frozen shoulder fixed in a week. Come early, within two weeks, and with chiropractic help you can expect the pain to be over in a month, perhaps less. FS TREATMENTS - a literature review.
From the Chiropractic Coalface
It was good to see a lady yesterday who brought her husband for a torn calf muscle. He was unable to drive...
Two years ago she had a severely frozen left shoulder. She has almost no pain. Read more at Arm pain case histories ...
Do you have any questions about shoulder and/or arm pain that is not getting better? Share it, perhaps others have some insights that may be of benefit.
Click below to see contributions from other visitors to this page...
Underlying conditions in frozen shoulder Not rated yet
Hi, I was wondering about the possibility of another illness causing my double frozen shoulder. I've been in PT for a month with no change. Just pain …
Frozen shoulder? Not rated yet
Hi there, I suffered a bad injury late sept 2013. I was hospitalised for two weeks due to post concussion syndrome and an onset of hemiplegic migraine …
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Interesting challenges of the day
1. Mr D has very severe midback back. He bent and twisted, feeding his son, and then laughed. Every breath is a nightmare. A sprung rib is every chiropractor's delight. He or she has golden hands. 30 percent better after one treatment.
2. Mrs C has a long history of severe, disabling migraine headaches since having her wisdom teeth removed. She clenches her teeth at night. After six treatments she has no migraines but some jaw joint discomfort remains; a bite plate is in the offing.
3. Mrs U has the trophy for the worst back this year. After major surgery with plates and screws two years later she still had paresis in the lower leg and severe disabling back pain. She's doing far better than expected, in no little part due to a lift in her shoe for a very short leg.
4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.
5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.
6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.
7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.
8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.
9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine.
10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.
11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.
12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.
13. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks 75 percent improved. No longer vomiting all falling. She's not enjoying the Brandt Daroff home exercises.
And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.
Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?
Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.
Your own unresolved problem. Pose a question
Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.
You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.
The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.