Diagnosis and Treatment of Shoulder Pain
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.)
Diagnosis of Shoulder Pain
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.
Chronic Shoulder Pain
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 an 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 from 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.
At Mountain View Pain Center we 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.