Shoulder Pain, Shoulder Injuries: Treatment and Therapies

Shoulder pain and shoulder injuries are one of the most common presentations into my chiropractic practice. There are a multitude of reasons why people present with shoulder pain complaints. It is very important to thoroughly examine the shoulder and make an accurate diagnosis of the cause of the pain, so that the appropriate treatment plan can be directed at repairing and strengthening the shoulder joint.

It is a very common occurrence for a person to come and explain to me that they have been diagnosed with bursitis or tendonitis in the shoulder. “Itis” is another way of saying there is inflammation, in this particular case, inflammation of the bursa or an area of the shoulder joint that is painful. When these problems occur together, and because there is a limited amount of space within the shoulder joint, the muscles and tendons become irritated and squeezed between the humerus and the shoulder blade, “impinging” these structures. Repetitive movements and stresses irritate the tendons, muscles and associated soft tissues in the joint area. The symptoms of impingement syndrome can be very mild or very severe. The fluid filled bursa between tendon and bone, or tendon and skin, when inflamed is called bursitis.

Symptoms of impingement syndrome or bursitis usually include a gradual onset of pain, most commonly in the upper arm or shoulder region. Once irritated, the tendons are easily inflamed and the swelling continues to irritate

and cause more pain and inflammation. Sleeping on their side or on the shoulder can be painful and difficult. If the front area of the upper arm and shoulder area is involved, the biceps tendon may be exhibiting some tendonitis also. It is fairly common to see pain referral to areas in the forearm and elbow also.

Consultation and examination of an individual with impingement syndrome or bursitis symptoms would include a thorough history, a physical exam, and other tests such as imaging (x-rays or MRI) and neurological tests may be necessary. The most common approach to treating the shoulder pain with conservative management includes rest initially from sports, work related activities, or heavy lifting, that may have been part of the initial injury causing the irritation and inflammation. Ice, and alternating ice and heat combined may help to reduce or limit the inflammation. Some gentle shoulder stretching, and strengthening exercises may be added once the pain starts to reduce.

Chiropractic therapies and low force manual adjustments are a safe, effective and gentle approach to treating the shoulder joint and the associated rotator cuff tendons. This may help to increase circulation into the area, break down any adhesions in the joint area, gradually increase the range of motion, and improve the exchange of nutrients within the injured tissues to reduce inflammation and accelerate the repair process.

Individuals with shoulder bursitis normally respond to conservative non-surgical treatments. The response time varies from person to person but usually a month to three months is a normal timeframe for resolution of symptoms or significant improvement. A longer timeframe may be required for a more optimal healing response. In severe cases where a person has not responded to conservative care or there is advanced damage to the involved area, shoulder surgery may be a necessary step.  Dr. Burns is one of only a handful of chiropractors in the country with Operating Room privileges and can perform manipulation under anesthesia to restore the normal Range of Motion in a frozen shoulder; this is an important modality that may help a patient to avoid surgery on the affected shoulder.

Dr. Paul Burns is a Chiropractor specializing in pain management and sports injuries.  He has worked with many college and pro teams, including the Denver Broncos, the ATP and Wrangler Sports.  His multidisciplinary practice is located in the Denver Tech Center and offers the latest in evidenced based practice methodology, techniques and technology.

For more information, visit www.DrPaulBurns.com and/or call 303-694-9759.