The shoulder joint is one of the most complex in the body and its’ unique design allows for lots of mobility, but unfortunately this also means less stability and thus it can be prone to injury. At any one time 7% (1) of the population are suffering with shoulder pain and this figure rises in the elderly up to 26% (2).
Due to the complexity of the shoulder joint the cause of the pain is usually due to a multitude of reasons, and in fact it does not always stem from the shoulder itself as it is a common area for referred pain (a phenomenon where the pain is perceived in a different location to that of the actual structure that is responsible for it). There are many pain sensitive structures around the joint including muscles, ligaments, bursas, tendons and anyone of the four joints which make up the shoulder girdle complex glenohumeral, acromioclavicular, sternoclavicular or scapulothoracic. Its’ function is closely linked to that of the neck and back as the muscles which function over the shoulder attach to the neck and some extend as far as the low back. The resultant effect is poor biomechanics and dysfunction in these areas can lead to an increased load at the shoulder joint and thus the development of symptoms.
Due to wide diversity of shoulder complaints and their underlying causes the treatment for shoulder pain varies dramatically for different presentations. Our chiropractor will take into account the findings from your case history and your physical examination and devise an individual package of care based on the recent research and years of clinical experience. Treatment may include a combination of any of the following, manipulation or mobilization of the shoulder and surrounding joints which will increase the available movement at these joints and thus eases the load on the muscles and tendons which work over the joint, relax the soft tissues surrounding the area and help alleviate any local nerve irritation. Deep soft tissue work (cross friction, massage, myofascial release techniques) to reduce any fibrous adhesions (knots) and tension which may have developed within the musculature , therapeutic ultrasound which may speed up the healing time and improve the quality of the scar tissue.
Most importantly your chiropractor will give you postural and ergonomic advice, and a home rehabilitative program to help address any imbalances and possible attributing factors and thus in turn reduce the likelihood of recurrence.
References
Urwin M, Symmons D, Allison T et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis 1998;57:649–55.
Chard MD, Hazleman R, Hazleman BL, King RH, Reiss BB. Shoulder disorders in the elderly: a community survey. Arthritis Rheum 1991;34:766–9
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