By Dr. Virginia Nsitem

Recently, a patient visited my office complaining of shoulder pain that has been getting worse over the past 2 months. She appeared to be in significant pain and was holding the arm close to her body. She explained that she could no longer groom her hair, put dishes away on upper shelves, and dress without help from her husband. On examination, she had very limited movement. She was concerned that her injury was permanent. I diagnosed her with frozen shoulder syndrome and she was happy to hear that she was a good candidate for rehab treatments to relieve her pain and restore movement and shoulder function.

 The shoulder joint

 The shoulder joint is formed by the joining of the humerus bone (upper arm bone), the scapula (shoulder blade) and the clavicle (collar bone). The stability is provided by the various muscles, tendons, ligaments, and other soft tissue structures around the joint. A group of muscles, called the rotator cuff muscles, help stabilize and move the shoulder joint. Cushioning sacs, called bursa, prevent soft tissues from rubbing against the bones.

  Injury to the shoulder muscles, tendons, ligaments, bursae, and bones can lead to pain and loss of function.

Common shoulder joint injuries

 Rotator Cuff Injuries of the shoulder can range from tendinitis to severe tears of one or more rotator cuff muscles. This shoulder injury can be caused from overuse or repetitive stress of the shoulder, or trauma to the shoulder joint. Symptoms of a rotator cuff injury include:

• Shoulder pain, instability, and weakness
• Swelling at the shoulder
• Reduced shoulder movements and a feeling of “catching” or “popping”
• Shoulder pain with overhead activities

Frozen Shoulder Syndrome, also called adhesive capsulitis, is the term used to describe severe pain and stiffness at the shoulder that has occurred for at least one month. This problem can develop gradually following trauma to the shoulder, lack of movement following surgery to the shoulder or chest, or after having the shoulder in a sling for a long period of time. The shoulder “freezing” can last several months before the joint starts to “thaw” and movement returns to the shoulder. Symptoms of a frozen shoulder include:

• Shoulder pain that is dull and achy
• Severe shoulder stiffness lasting over 1 month
• Severe limitation of shoulder movements, especially lifting the shoulder up or reaching behind with the shoulder
• Difficulty with daily tasks such as grooming your hair etc

Shoulder Injury Treatments

 Chiropractors specialize in diagnosing, treating, and rehabilitating injuries of the muscles, joints and nerves.  It is important to see your chiropractor or physician for an accurate diagnosis, as your rehabilitation program may vary, depending on your diagnosis and the severity of the injury.

Treatment for rotator cuff injuries or frozen shoulder syndrome may include:

• Chiropractic techniques: Manual therapies are used to improve the flexibility of the muscles and tendons, and restore proper movement of the shoulder joint. Therapeutic Laser therapy is a useful device that works to reduce inflammation and pain, and allow the patient to start the exercise portion of the rehabilitation program. Cold therapy (ice) can be helpful in the initial stages of inflammation to reduce the pain and swelling. Heat application can soothe tight muscles and help with flexibility exercises.
• Exercises (stretching and strengthening) are introduced gradually, and help to improve the flexibility, strength, and stability of the shoulder joint.
• Massage therapy and Acupuncture: Studies have shown that these techniques may be helpful in providing a pain-relieving effect throughout the body, an anti-inflammatory effect, and a general sense of improved well-being. Acupuncture treatments may also help to speed up the recovery when combined with the manual therapy and exercises.
• Modifications at home: Using a pillow between the arm and your body may help you sleep more comfortably at night. Your chiropractor can advise you on other ergonomic modifications, based on your injury, to help you return to your daily activities.

Dr. Virginia Nsitem is a chiropractor specializing in laser therapy for muscle, joint, and nerve injuries, and is a Fellow of the Royal College of Chiropractic Sports Sciences in Canada. She may be reached at (905) 275-4993, or by email at totalhealth@bellnet.ca

Stop the Pain … Before the Pain Stops You!