The
shoulder joint is supported by more muscles than any other joint in the
body; however, because of the lack of bony structure and the
shallowness of the shoulder joint, the shoulder is also the most
commonly dislocated joint in the body. Likewise, subluxations (small
dislocations) and tendonitis problems are also frequently found in
patients with shoulder complaints. These less severe but painful
shoulder conditions are often the result of repetitive activity or
excessive use of the muscles and the ligaments that surround the
shoulder joint. For instance, bursitis (a condition of inflammation
surrounding a joint) is commonly found here. Shoulder injuries,
arthritis, and pathologies (such as cancer) may also cause shoulder
pain.
The shoulder is also a common
source of referred
pain (pain being transmitted to the shoulder from another source.)
People with neck conditions may experience this type of referred pain
due to the irritated nerves that travel from the neck into the
shoulder. Referred pain can also come from diseased or distressed
organs. Organs such as the pancreas, liver, or heart can refer pain to
the shoulder. Certain other structures in the and disorders in the
digestive tract can refer pain to the shoulder as well such as a hiatal
hernia or the ileocecal valve (a valve in the digestive tract between
the small and large intestine, near the appendix.)
A
proper shoulder diagnosis is needed to help determine the nature (where
the pain is coming from) and the degree of involvement of the shoulder
condition. An examination and history aid the doctor in determining a
proper diagnosis. In addition, x-rays of the shoulder may be helpful to
determine alignment, check for fractures, visualize bone damage
(arthritic changes or bone loss), or find other osseous (bony)
abnormalities.
The way your shoulder
moves with and
without pain can play a key role in determining the type of shoulder
problem you have. For instance, tendonitis conditions generally are
exacerbated (hurt more) when the muscle that attaches to the tendon is
forcibly contracted. On the other hand, bursitis conditions generally
hurt more at rest, after a period of shoulder use. Additionally, the
ability to have your arm passively moved (moved by someone else)
through a motion you cannot duplicate actively (move by yourself)
generally indicates a muscle weakness. Whereas an inability to move
your shoulder or have your shoulder moved usually indicates a bony
obstruction or soft tissue swelling.
In
some cases
of chronic shoulder dislocation, chiropractic treatment care can be a
welcome non-surgical alternative. Shoulder joint manipulation,
localized therapy, and muscle-strengthening exercises may reduce the
chances of future dislocations. A chiropractor can also order a MRI
(Magnetic Resonance Imaging – A way to see soft tissue on a
x-ray-like film) to help determine the integrity of the shoulder joint.
Your chiropractor may also work with an orthopedist if needed.
Older
patients that have loss of motion due to degenerative arthritis may
benefit form chiropractic care, too. Often improvement can be made
gradually in the shoulder joint through careful and patient stretching,
relaxation, and passive motion therapy. Although many older patients
will suffer from bursitis or arthritic shoulder conditions, there is
one complaint about the inability to raise the arms out to the side
above the level of the shoulders. In many of these complaints, the
problem really isn’t in the shoulder at all. The reason why
the
arms cannot be raised above the level of the shoulders is because the
spine has become kyphotic (bent over forward.) Even a child cannot
raise his arms above his shoulders if his back is bent over.
Chiropractors
treat thousand of shoulder problems each year. Once your shoulder
problem has been diagnosed by your chiropractor, a course of treatment
can be discussed. Most shoulder problems respond well to manipulation.
In addition, other therapies can be applied if needed. The goal is
always to reduce pain and swelling while improving the shoulder joint
motion. In addition to restoring motion, strengthening the muscles that
support the shoulder joint will also help to prevent future re-injury.