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, it is also the most commonly dislocated joint in the body. Likewise, patients with shoulder complaints often have issues with subluxations (small dislocations) and tendonitis. These conditions, while less severe (but still painful), 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 other conditions (such as cancer) may also cause pain.
The shoulder is also a common source of referred pain, which is when pain is transmitted to the shoulder from another area. People with neck pain may experience this due to the irritated nerves that travel from the neck into the shoulder. Referred pain can also come from diseased or distressed organs, such as the pancreas, liver, or heart. Certain other structures or disorders in the digestive tract can refer pain to the shoulder as well, such as a hiatal hernia or the ileocecal valve (between the small and large intestine, near the appendix).
You need a proper shoulder diagnosis in order to help determine the nature (where the pain is coming from) and the degree of involvement of a shoulder condition. An examination and history aid the doctor in determining a proper diagnosis. In addition, x-rays of the shoulder could help to determine alignment, check for fractures, visualize bone damage (arthritic changes or bone loss), or find other osseous (bony) abnormalities.
How your shoulder moves with and without pain can help determine the type of shoulder problem you have. For instance, when the muscle that attaches to the tendon is forcibly contracted, it generally will exacerbate the tendonitis (hurt more, in other words). 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. If you are not able to move your shoulder or have your shoulder moved, this usually indicates a bony obstruction or soft tissue swelling.
In some cases of chronic shoulder dislocation, chiropractic treatment care are 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 an MRI (Magnetic Resonance Imaging – a way to see soft tissue on an x-ray-like film) to help determine the integrity of the joint. Your chiropractor may also work with an orthopedist if needed.
Older patients that have loss of motion due to degenerative arthritis may benefit from chiropractic care, as well. Often, the shoulder joint function can improve through careful stretching, relaxation, and passive motion therapy. Although many older patients will suffer from bursitis or arthritic shoulder conditions, there is a common complaint about the inability to raise the arms out to the side, above shoulder level. The problem in many of these cases isn’t with the shoulder at all, but actually because the spine has become kyphotic (bent-over forward). Even a child cannot raise their arms above their shoulders if their back is bent-over.
At Mountain View Pain Center, we treat thousand of shoulder problems each year. Once you receive a diagnosis from your chiropractor for your pain, they will help you decide on a course of treatment. 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 also 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. If you have questions please contact one of our offices.