Shoulder pain can be extremely debilitating, making it impossible to work or be active. When visiting your doctor, you may be advised to receive a corticosteroid injection to relieve pain. Although this can at times be the only option, it is highly recommended to attempt a conservative therapy first. It is usually advised to leave surgery or injections as a last resort, if non-surgical methods provide no results.
The proper treatment plan for your shoulder will depend on a proper diagnosis of your complaint. This will depend on your age, expectations and current level of health. For example, many older individuals who come with non-traumatic shoulder pain will often have supraspinatus muscle tears due to natural degeneration, developed over many years. Because this muscle has a poor blood supply, it is prone to injury in older individuals, or those who perform many overhead activities. In such cases, the most important factor in recovery is adjusting activities and lifting technique. Discuss the best options available with your chiropractor.
Most working people tend to have shoulder complaints related to daily posture and activities. These complaints can be treated with soft tissue therapy without the need of corticosteroid injections. One common diagnosis for shoulder pain is bursitis. This is a condition where the bursa becomes inflamed, causing compression in the area, resulting in a sharp pain in the shoulder with certain movements. The supraspinatus tendon becomes impinged under the swollen bursa, creating pain. Generally, the cause of the impingement is repetitive arm movements, such as cleaning, wiping, sweeping, or any activity that involves the arms.
After a proper evaluation, the affected muscle could treated, allowing proper scapular motion to return, releasing pressure on the bursa and restoring proper motion to the joint. Proper joint motion in the thoracic vertebrae must also be ensured for optimal function. After proper joint motion and scapular position is restored, it is important to be aware of aggravating activities in order to avoid recurrence of pain, and if needed, perform exercises to maintain stability and strength. Discuss with your chiropractor how you could best maintain scapular stability in the long term.
The symptoms of bursitis/impingement syndrome can vary depending on severity, but can include:
- Pain or difficulty reaching behind your back
- Pain or weakness noted when trying to lift your affected arm
- Pain when lying on the affected side when sleeping
- Pain radiating from the shoulder down to the elbow or hand
- “Painful arc sign”
- Pain when performing daily tasks such as getting dressed, putting on a seatbelt or driving.
Risk factors for an impingement syndrome
Any sport, activity or occupation that involves overhead movements will likely make one more susceptible to impingement syndromes. It is more commonly seen in males and those above 40. In older individuals this can be secondary to partial supraspinatus tears due to degeneration of blood supply to the muscle. Younger adolescents may also experience such symptoms, usually due to overactivity with throwing, or overhead sports, such as tennis, volleyball, baseball, or handball.
Exercises and stretches are good, but are not necessarily a replacement for treating bursitis and impingement syndrome. These complaints are usually result of daily activities, and have a tendency to come and go over the years, depending on changes in activity. Discuss with your chiropractor the best ways to avoid complications with shoulder pain in your daily life!
