Common Issues That Cause Shoulder Pain

According to the CDC 52.5 million American adults suffer from joint pain,  9% of which suffer from shoulder pain. Shoulder pain has many causes but the 7 most common according to the American Academy of Orthopedic Surgeons are:

  • Bursitis
  • Tendinitis
  • Tendon Tears
  • Impingement
  • Instability
  • Arthritis
  • Fracture

This article will discuss what each of these infirmities is and if it is possible for it to be treated as well as what those treatment options are.

Bursitis

Bursitis is the inflammation of a bursae, a fluid filled sac that is intended to lubricate and cushion the joint to allow for ease of movement. Typically bursitis is caused by an overuse of a joint that may be experiencing segmental dysfunction (misalignments of the joint caused by altered muscle tone, scar tissue, worn cartilage, or other such causes).

Bursitis of the shoulder can be particularly painful especially during movements such as abduction of the shoulder, a movement where the upper arm is raised out laterally to the side. The good news about bursitis is that it can be treated non-surgically and without the use of drugs through gentle chiropractic techniques like Directional Non-Force Technique®, ice, rest, ultrasound therapy, and eventually rehabilitative exercises that emphasize proper joint motions to decrease the chances of future flare ups..

Tendonitis

Tendonitis, much like bursitis is often the result of overusing a joint suffering from segmental dysfunction. In the case of tendonitis, it is the connective tissue that attaches the muscle to the bone that becomes inflamed causing pain in the shoulder joint during activities that load weight on the tendon or motions that put pressure on the tendon.

Like the bursa the non-surgical and non-pharmacological treatment options are very virtually the same as the options for the bursitis. The main goal with both of these conditions is to remove the inflammation and restore proper tone to the supporting musculature so the joint will travel through the proper movement patterns. To accomplish this goal most efficiently, segmental dysfunction must be corrected in all shoulder components and any structures upstream in the proper direction for each individual structure of the neurological chain in order to restore proper proprioception (the brain’s ability to perceive where a body part is in time and space) and thus proper function to those anatomical locations.

Tendon Tears

Tendon tears are just that, a tear to some degree in the connective tissue that joins a muscle to a bone. This type of injury can be traumatic or due to chronic wear and tear. Typically this occurs in either the long head of the bicep tendon or the supraspinatus tendon however it may occur in any tendon. Depending on the degree of the tear surgery may or may not be required, however it is best to try a conservative approach to treatment before going to the more invasive procedures.

For tendon tears increasing blood flow to the tissue is important so ultrasound therapy is a good modality of choice improve circulation as well as reduce inflammation in the area. DNFT® chiropractic is also a great way to correct neurological deficits that may result in imbalanced muscular tone that may have contributed to the problem in the first place. After inflammation has subsided, rehabilitative exercises are in order to strengthen the area and train the muscles to fire in the correct order so that the joint will track correctly and reduce the likelihood of further damage. Depending on the phase of healing and other circumstances, your health care provider may recommend ice or heat to be applied as well.

Impingement

Shoulder impingement is a common cause of shoulder pain and shoulder weakness, especially in people that perform many overhead tasks. The cause of impingement as it relates to the shoulder is the entrapment of the supraspinatus tendon between the head of the humerus (the long bone of the upper arm and the clavicle (collar bone). This may be due to muscular imbalance or movements like raising the arms laterally while internally rotated.

The best way to prevent shoulder impingement in the first place is to strengthen the external rotators and posterior chain muscles. This means  balancing the strength and tone of the rear shoulder muscles, maintain good posture and keeping your hands at a neutral (thumbs facing straight forward with palms facing straight to one another) or anatomic position (palms facing forward) whenever possible.

Most of the treatment for this problem can be solved with rehabilitative exercise. In order to manage the inflammation, ultrasound therapy is a great modality. To assist in restoring proprioception and helping the brain have more awareness of body position and restore proper tone to the muscles of the shoulder joint as well as aligning the bones of the joints.

Here is an additional article on shoulder impingement.

Instability

Instability usually follows after a traumatic injury in which the muscles are strained and / or the ligaments are sprained or ruptured. A common cause of shoulder instability is a SLAP tear, this is a Superior Labral from Anterior to Posterior tear. So what that means is that the labrum, a fibrocartilage rim that deepens the socket of the shoulder, is torn on the upper aspect in a front to back direction. This causes a loss of vacuum type suction that normally keeps the head of the humerus tight held inside the glenoid cavity (shoulder socket). After experiencing a SLAP tear, it is important to strengthen the muscles surrounding the shoulder joint as they are now the primary means for providing stability to the joint.

There are cases in which surgery is required, but in many instances patients will only require exercises to strengthen these stabilizing muscles to regain strength. DNFT® chiropractic care may help in the reduction of pain and hypertonicity of the muscles involved in the shoulder joint. Other treatments like ultrasound may help to reduce inflammation as well.

Arthritis

Arthritis, more specifically osetoarthritis or degenerative joint disease (DJD) is another problem affecting patients and causing shoulder pain. Degenerative joint disease is usually the result of a chronic injury or overuse that has begun to lay down osteophytes, bony protrusions from the edges of the joint.

Many times arthritis can be treated with DNFT® chiropractic and tends to respond well. Range of motion exercises are also very important in preventing pain. In rare cases surgery is required as the osteophytes can wear on tendons resulting in additional complications.

Fracture

Fractures are when the bone has a disruption in the cortex (outer layer of solid bone). For any fracture medical intervention is advised. Fractures are not able to be treated by chiropractic until after the fracture has healed. After the cortex is intact and adequate for chiropractic care, the chiropractic physician may then be able to treat residual complications. These complications may include myofascial restrictions, stiffness of the joint, scar tissue, and muscle weakness among others.

If you suspect a fracture seek medical care for treatment.

This article is intended to educate patients experiencing shoulder pain about non-surgical and drug-free options for treating their issue. For more help, schedule an appointment with your health care provider. If you are in the Franklin or Brentwood Tennessee area, call

(615) 415-0125 to schedule with Dr. Chance Moore of White Feather Chiropractic.