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Shoulder Pain Research - Frozen Shoulder - Tennis Elbow - RSI - What does a chiropractor do for shoulder pain?

 

Chiropractic has never cured anyone of anything.

 

If we go looking for the named condition that Chiropractic can be applied to and produce change in we will find ourselves in a merry-go-round of symptoms, loosing sight of the whole because of an obsession with the parts. So the question of What can Chiropractic Cure should be changed to "How" can Chiropractic Assist? The answer is simple. A well functioning mind and body has a greater opportunity to heal, repair and function than a poorly functioning one. A well functioning mind and body depends to a significant degree on a well functioning spine and nerve system. This is Chiropractic's contribution.

 

People find that chiropractic's ability to produce better spine and nerve system function changes their life expression. There are thousands of symptoms and conditions that chiropractic has been associated with helping, however don't ask "Can Chiropractic Cure this or that condition" - instead ask "If my mind and body was functioning better through Chiropractic would I be better placed to handle this condition?"


Shoulder Pain Research


"In the 216 studies of frozen shoulder done at Malmo, this condition included pain either in the neck or radiating. Within six weeks the shoulder and arm pain had resolved completely."

Feeley KM. Conservative Chiropractic Care of Frozen Shoulder Syndrome: A Case Study. Chiropractic Res J, 1992; 2(2):31-37


Frozen Shoulder


Frozen shoulder is the term commonly used to describe persistent shoulder pain and restricted movement. However, shoulder problems are often misdiagnosed and as with any other joint problem, the success of any treatment depends on correct diagnosis and cooperation between patient and practitioner.


The purpose of this information sheet is to clarify some common misconceptions of shoulder problems.


What is a frozen shoulder?

Frozen shoulder refers to loss of arm movement at the shoulder joint combined with inflammation of the tissues within the joint capsule that surrounds the shoulder. These tissues become thickened and shortened and eventually "stick" together, hence the medical term, adhesive capulitis.


What are the symptoms?

Initially, there is progressive limitation of all movements of the shoulder. This may follow a recent minor trauma, dislocation, prolonged immobilisation, heart attack (myocardial infarction) and sometimes neck problems (cervical radicultis). Pain may or may not accompany this, although pain will be felt if you try to exceed the limited movement. This stage is sometimes referred to as the "freezing" stage.


Eventually, the condition progresses until all movement is greatly restricted "frozen" stage. Usually, no pain is felt at this stage. The reverse of this process occurs during the recovery, when pain is again experienced but once movement is restored, the pain diminishes.


Early diagnosis is vital because the condition is reversible. Once it has progressed into the adhesive/frozen stage, some persistent restriction may remain. The recovery period varies depending on how long the problem has been there and the severity of it.


Rotator cuff tendonitis/ Tear

The rotator cuff muscles play an important role in the movement of the shoulder. They consist of the supraspinatus, infraspinatus and teres minor muscles. The rotator cuff tendon is a major source of pain and disability. If it becomes inflamed (tendonitis) or torn, voluntary abduction, elevation and rotation of the shoulder is lost.


However, the practitioner will be able to move the shoulder noting only a slight loss in movement due to pain. Whereas with frozen shoulder, the practitioner will not be able to move the joint. Rotator cuff muscle pain is usually due to trauma of overuse movements.


Bursitis

Bursas are fluid filled sacs that surround certain joints of the body and act to prevent excess friction between tissues and/or bony surfaces.


In the shoulder, you will find the sub deltoid bursa that lies underneath the deltoid muscles (these muscles make the rounded shape of the shoulder/arm). The bursa can become inflamed or pinched which in turn will produce pain in some limited and heat production may be felt.


Cervical Referral

When joints become fixated and irritated in the lower part of the neck, pressure may occur on the surrounding nerve fibres. These nerves supply information to the muscles of the shoulder and if these nerves become spasmed and weakened and movement will become limited. There is no actual damage to the shoulder joint itself and no voluntary decrease in movement will be experienced.


Other causes of shoulder pain.

Obviously, fractures and dislocation will cause pain but, due to the severity of these problems, they are treated at the A&E departments in hospitals.


Arthritis of the shoulder joint, natural wear and tear will produce shoulder pain but usually you will have experienced previous problems.


Gall bladder inflammation (cholecystitis) can refer pain into the right shoulder joint but with no loss in actual movement of the shoulder joint.


Heart attacks can refer pain into the left shoulder and arm.


Treatment

When the cause of the shoulder problem has been established, the appropriate treatment can be initiated. This can range from chiropractic adjustments and mobilisation, icing, rest, modality use (ultra sound and interferential machines) and eventually exercise to improve movement and strength.


How long you decide to benefit from chiropractic care is, of course, always up to you, but for effective long term results, always follow the chiropractor’s recommendations.


Tennis Elbow


At this time of the year, when the sun starts to shine and Wimbledon is just around the corner (June 21-July 4) many people who have been fairly sedentary all through the winter, get out their tennis racquets and dust them off.


Over the next few months, chiropractors are going to see many injuries related to this sport because people have taken too enthusiastically to it.


The risk of injury in any type of sport increases with age because both the muscle strength and the elasticity of the ligaments decrease past the age of about thirty.


Obviously, if you are very fit, you warm up, you train appropriately throughout the year and you are careful not to continue exercising if you are ill or are injured, you are less likely to need help from a chiropractor.


The so called tennis elbow is one of the most common injuries seen from tennis, together with back and shoulder injuries. The term tennis elbow is used to describe pain found on the outer part of the elbow and the upper part of the forearm. Tennis elbow is due to inflammation of the tendon and bony protuberance at the outer part of the elbow. Tennis elbow is in fact an overuse injury. Repetitive, forceful movements at the wrist, which bring the thumb outwards and the palm upwards, can cause shortening of the muscles. This causes the attachment of these muscles at the outer part of the elbow to be placed under considerable tension and a sudden movement at the wrist may cause a tear in the muscle and tendon.


The repetitive action of gripping, twisting and moving the wrist can cause inflammation of the tendon that attaches to the muscles of the forearm which straighten the fingers and the wrist.


What are the symptoms?
  • Pain over the outside of the elbow, which may travel up or down the arm
  • Wrist weakness
  • Tenderness over the outside of the elbow.
What are the causes of tennis elbow?

Obviously, playing tennis may be one of the cause e.g. if you have a faulty backhand technique or a faulty grip, but other racquet sports can also cause the same injury. You may be surprised to hear that D.I.Y. and gardening can cause this injury (e.g. the use of a screw driver or the use of garden clippers).


Professionals such as electricians and carpenters are also prone to this injury.


Tennis elbow is a very disabling condition for some people. Some sufferers find it difficult to perform simple tasks like writing, spreading butter on a sandwich or holding a cup of tea.


What is the treatment?

Initially, it is important to reduce the inflammation and to rest the elbow as much as possible. The use of ice is very effective in the first two or three days but sometimes has to be used for a longer period. Sometimes a tennis elbow brace may be needed (not an elbow strap), particularly if the problem is persistent.


Obviously, any faulty techniques in the game must be corrected. The chiropractor will also examine any area relating to the function of your elbow and muscles of the forearm, such as the wrist shoulder and more importantly the neck.


The second part of the treatment involves increasing the blood circulation to the tissues. This can be done by alternating hot and cold or the use of ultrasound. When the pain has subsided, it is possible to undertake a rehabilitation programme of power and stretching exercises for the elbow and the affected muscles, taking care that the exercises are done slowly and carefully so as not to make the condition recur.


Most injuries occur either at the beginning or the end of the game. Often, at the beginning of the game, this is because proper warm up techniques haven’t been used whilst towards the end of the game, injuries may occur when the people are fatigued.


Don’t forget that a tennis ball travelling at 30 miles per hour is equivalent to lifting 55lbs!

RSI (Repetitive Strain Injury)


As more and more work, education and recreation involves computers, everyone needs to be aware of the hazard of RSI to the hands and arms, often resulting from the use of keyboards. This can be a serious and very painful condition that is far easier to prevent than to cure once contracted, and can occur even in young physically fit people.


What is RSI?

RSI is caused by mechanical irritation which upsets the body’s highly turned natural balance. It is an inflammation of the tendon sheaths in the finger and hands, wrists, and elbows which may eventually progress to the upper arms and shoulders. Repeated physical movements cause damage to tendons, nerves, muscles, and other soft body tissues.


Often stiffness in the spinal joints of the neck and upper back aggravate or even cause RSI in the arms and hands. Spinal problems cause irritation of the nerves as they exit the spine and this leads to problems in the muscles they supply.


What are the symptoms?
  • Tightness, discomfort, stiffness, or pain in the hands, wrists, fingers, forearms or elbows
  • Tingling, coldness, or numbness in the hands
  • Clumsiness or loss of hand strength and coordination
  • Pain that wakes you up in the night
  • Feeling a need to massage your hands, wrists and arms.
Areas where design may cause problems
  • Head angle
  • Document Holder
  • Arm angle
  • Lumbar support
  • Chair height
  • Arm rest
  • Leg room
  • Foot rests
  • Working height
  • Keyboard location
  • Display height
  • Display angle
  • Viewing distance
How do I prevent it? Self-help tips for computer users:
  • Don’t pound on the keys: use light touch.
  • Take lots of breaks to stretch and relax. This means both short breaks every few minutes and longer breaks every hour or so
  • Fidget a lot! Hold the mouse lightly! Learn and use keyboard commands if possible, as no pointing device is risk-free. Keep your arms and hands warm. Cold muscles & tendons are at much greater risk for overuse injuries.
  • Eliminate unnecessary computer usage. No amounts of ergonomic changes, fancy keyboards, or exercises are going to help if you are simply typing more than your body can handle
  • Consider voice recognition. Software that allows computer control or full vice dictation is becoming more powerful and less expensive
  • Evaluate other activities. Sports, carrying children, hobbies requiring intense small work (like knitting), and excess effort/tension in other daily things may have enormous impact too
  • Pay attention to your body. Pain is your body telling you that it’s in big trouble, but learning what is comfortable or awkward for your body before your in pain may prevent injury
  • Kids are at risk too: increasing hours in front of the computer at home and school, using equipment that is not set up correctly for their size.
What If I have symptoms of RSI?

We all have occasional aches and pains that go away in a day or two, especially when we overdo anything. But if you have the symptoms listed above regularly when you are using a computer, you should see a chiropractor, as soon as possible. Dealing with this early is critical to limiting the damage. Remember that "RSI" is a mechanism of injury, not a diagnosis. Where or how seriously you are injured, and how best to treat it, varies immensely form person to person.


Treatment

RSI problems may be local or diffuse conditions. Local, such as: specific muscles, tendons, nerves being inflamed or injured. Diffuse, often mistaken for local problems, can involve muscle discomfort, pain, burning and/or tingling; although they’re not necessarily "the problem".


Prevention is still the best prescription. No wrist splint, arm rest, split keyboard, spinal adjustment, etc. is going to permit an immediate return to work at full speed if you’re injured. It is important to make the long term changes in technique and work habits that initially caused the complaint. Healing could take months, sometimes years. Many RSI victims do regain the ability to work and substantial freedom from pain, but find that they remain vulnerable to re-injury and flare-ups.


Chiropractors adjust the affected joints to restore full motion, reducing stress on the nearby muscles, tendons and nerves.


Massage and specific exercises will often be prescribed. The spinal locking can be discovered before symptoms manifest and so chiropractors can prevent RSI in the first place.


What can a chiropractor do for shoulder pain?


What does a chiropractor do for shoulder pain?


Your chiropractor will perform a complete consult and examination and may take radiographs (x rays). After review of the examination findings your chiropractor will recommend an appropriate and individual care program. Treatment consists of specific manual adjustments, to the individual joints of the body and spine, which restore damaged neurologic function.