Frozen shoulder causes and chiropractic treatment outlines our protocol in the management of this very painful and debilitating condition.
An Adhesive Capsulitis, as it is known in medical terminology, is one of the most disabling and painful conditions to confront the healing professions.
This page was last updated by Dr Barrie Lewis on 24th January, 2019.
Three years of misery!
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A recent literature search of frozen shoulder treatments by a team of medical experts found that no one frozen shoulder treatment or team of experts has the monopoly on solutions to this tough problem, though some treatments do help. The most common treatment at the medical coalface, anti inflammatory drugs was not even considered, having absolutely no scientific basis in the treatment of this nasty condition. They simply don't help.
Classically, a frozen shoulder takes 2 to 4 years to resolve, but after four years some 6% still have extreme pain and disability.
Frozen shoulder causes and chiropractic treatment.
Frozen Shoulder Chiropractic was also not considered, there being no scientific basis for treatment by us either.
But, and it's a big but, as Carl Sagan said, "Absence of proof is not the same as proof of absence."
We chiropractors simply haven't done the research.
"The problem with Frozen Shoulder is that there is no 'best' answer yet, medical or other, based on the existing literature. Personally I think FS is one of the most variable conditions - every patient is different."
Dr Shawn Thistle, DC, chiropractic researcher.
Research Review Service
Another but; at the chiropractic coalface, there are few conditions that I love more than the challenge of a frozen shoulder. In my experience, it's rare that the pain is not substantially less within six weeks, often three weeks, and the range of motion almost fully restored within a year.
The last ten percent of external rotation may take longer but, in the absence of pain, it's not disabling at all. But can that audacious claim be demonstrated scientifically?
What treatments do help?
That literature search found that there was some scientific basis that the following treatments might help:
You will notice considerable contradictions in the above, therapy in the hands of one practitioner not being the same as in the hands of another.
Frozen Shoulder causes vary enormously but usually involve an injury to the lower neck or the shoulder girdle.
Most authorities describe frozen shoulder as idiopathic. No known cause. It comes of itself. And goes of
itself? Yes, after about three years of intense misery. In all
probability there are numerous causes. Minor trauma, rotator cuff
strains, fractures, biochemical and probably others.
What does Chiropractic have to add?
The basis of
chiropractic is that many of the conditions affecting the arm, be it carpal tunnel syndrome, tennis elbow or frozen shoulder are caused by
nerve irritation. That could be a nerve root impingement, an inter scalene triangle impingement, in the ulna groove, between the bellies of the pronator teres muscle.
Certainly the chiropractic examination of the frozen shoulder usually unearths some of the following:
Adson's test confirms the the tingling comes from an irritation within the Inter Scalene Triangle rather than a nerve root impingement. See the video at Adson's test but this is not a test to be done at home. It requires a great deal of experience to interpret the results.
The triangle made up of the scalene muscles and the first rib is one of the most sensitive areas in the lower neck. Through this narrow fissure travel the 5 trunks of the brachial plexus and the subclavian artery, all vital in the normal function of the arm. Inter scalene triangle.
Scalene muscle spasm, first rib fixation and even cervical ribs should be considered.
In short frozen shoulder causes are extremely variable and the condition presents in many different ways. In one case it's internal rotation that is most affected, others external rotation. In one case a rhomboid spasm is key, another the levator scapular or subclavius muscle...
Thus frozen shoulder causes and the chiropractic treatment thereof may be quite variable.
In my experience what they all have in common is
What is uncertain is whether that first rib fixation, affecting both the blood supply and nerve supply to the shoulder is a cause, or a subsequent result of the condition. Chicken or egg? Either way, both the blood supply and the innervation of the shoulder are compromised in the inter scalene triangle.
Chiropractic Frozen Shoulder treatments
Frozen Shoulder Causes and Chiropractic Treatment
Doctors learn a lot from their patients; they gain new and important insights. Today a middle aged man with a particularly stubborn frozen shoulder of some three months duration, just getting worse despite orthodox treatment shared his experience that from the start every chiropractic treatment increased the range of motion, and decreased the pain; but that without the exercises done daily, it slowly slipped back to its former stiffness.
He felt that the home exercise programme was to maintain the increased range of motion from the treatment, until the next consultation when there would again be another small improvement, yet again to be sustained with his own efforts.
In six weeks the pain is about 70% less and all the ranges of motion except for external rotation have improved greatly. Most important, nights are no longer agony.
You can live with some residual stiffness, but not with pain that wakens you through the night and is so disabling during the day. He can now reach his back pocket wallet.
He is already into the thawing phase.
Frozen Shoulder Causes and Chiropractic Treatment