Mechanical stress over the years of our life is often considered as a primary contributor to the deterioration of joints, ligaments, and tendons. Commonly known as arthritis or osteoarthritis it primarily affects the larger joints of the body such as the hips, knees and the lumbar spine. The shoulder is also prone to undergoing arthritic change primarily due to its level of mobility. The trade off of having tremendous mobility in the shoulder under normal circumstances is a joint with inherent instability. This leave us prone to mild injuries because in the shoulder we sacrifice stability for mobility. With each subsequent mild injury to the shoulder joint our body adds more and more scar tissue in an effort to stabilize the shoulder and over time this can lead to a more serious chronic pain syndrome.
What’s Involved in Chronic Shoulder Problems?
Chronic pain of the shoulder typically involves a small group of shoulder stabilizing muscules known collectively as the rotator cuff. The four rotator cuff muscles attach themselves between the scapula (shoulder blade) at the back and from under the chest muscles at the front out to the tip of the shoulder. The names of the rotator cuff muscles are the supraspinatus, infraspinatus, subscapularis, and teres minor. As the rotator cuff muscles attach to the head of the humorous (arm bone) they form a broad tendonous sheath which is designed to support and strengthen the shoulder joint. However, the shoulder’s inherent mobility causes the soft tissues of the rotator cuff to undergo repetitive stress and strain. Each repetitive mild injury to the shoulder joint cause the body to infiltrate these soft connective tissue with more dense fibrous tissue (scar tissue) in an attempt to further stabilize the joint. As more and more scar tissue accumulates in the shoulder joint this can lead to adhesive capsulitis also known as frozen shoulder. This is the result of degenerative changes affecting the bursa (small bag of water which lubricates the shoulder joint) which can cause it to become inflamed (bursitis) with normal movement, leading to the two prominent symptoms of pain and restricted range of motion.
What are the Traditional Treatments for Chronic Shoulder Pain?
There is an orthopedic sub-specialty which focuses on treatment of chronic shoulder pain. Their primary treatment methodologies include long-term use of anti-inflammatory medication, corticosteroid injections if the medications don’t provide relief, and often times surgery to repair tears in the various rotator cuff tendons. Secondary surgeries known as “revision” surgery is commonly performed if the initial surgery is unsuccessful.
Can Chronic Shoulder Pain be Treated without Drugs and Surgery?
There is good news. In many cases, a more natural approach is possible, which focuses on utilizes the body’s natural recuperative ability. For many, chronic shoulder pain can be reduced and mobility can be improved through rehabilitative exercises and other activities. The objective of rehabilitative exercises is to increase the range of motion and flexibility while improving shoulder strength. The most frequent result is a reduction in the intensity and frequency of shoulder pain.
How Long will it Take to Recover?
Chronic injuries almost always require a long-term approach to treatment. It’s important to remember that the problem developed over time and will not be fixed in a matter of days or weeks. Progress can often happen in the short term where the pain can even disappear at times. However, consistent results in alleviating chronic shoulder pain requires an ongoing treatment plan.
Adding the rehabilitative activities as part of your daily routine is critically important. Chiropractic care can be of great benefit in getting the most from your exercise program. Regular chiropractic care improves mobility in your spine and reduces nerve irritation which may cause tight, inflamed muscles. The result is a body that is optimized for good health and full function. By enabling maximum spinal mobility and maximum function of your nerves, regular chiropractic care helps maximize your body’s ability to recover from pain and chronic injuries.
What Else Can I do to Speed My Recovery?
Adding an overall strength training program to your lifestyle is an important approach to managing chronic shoulder pain. Strength training should be done gradually but progressively, starting with light weights and low repetitions and building up repetitions over time before adding more weights. There are many exercises which can benefit the shoulder: seated press (dumbbell or barbell), lateral raises (dumbbell or cable), rows (seated or bent over), and internal and external rotation exercises done with light dumbbells on a flat bench. If you have had an acute shoulder injury you should start with simple rehabilitation exercises before preceding to rehabilitative strength training. Early rehabilitation includes pendulum exercises and finger-walking up a wall in both forward-facing and side positions.
Chiropractors are trained in injury rehabilitation and can help design an effective flexibility and strengthening program for improving shoulder function. If you are currently suffering from an acute or chronic shoulder injury give our office a call today to find out how we can help.
For Your Health,
Dr. Salvatore Minicozzi