(Keywords: acromioclavicular joint, rotator cuff syndrome, frozen shoulder exercises, arm pain treatments, chiropractic help )
FROZEN SHOULDER 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 period time, if not properly managed. Up to three years. 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.
Searching for something specific like Rotator Cuff syndrome ? Type it in here...
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.
What is a Frozen Shoulder? FS
FS 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.
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.
The diagnosis of FS 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 shoulder, particularly internal rotation, become severely limited. Chiropractic treats the frozen capsule particularly successfully, but it remains a nuggety problem.
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 40-50 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 - 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.
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 (inflammed joint capsule).
"Frozen shoulder is very poorly diagnosed and managed."
Dr David Connell, a consultant in radiology at the Royal National Orthopaedic Hospital in Stanmore.
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
CERVICAL RIBS ...
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.
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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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.
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