Shoulder Pain Treatment: A Jackson, NJ Chiropractor’s Perspective

The chiropractors here in Jackson, NJ see patients come in with shoulder pain fairly often. Shoulder pain occurs in up to 70% of people at some point in their lives.  The shoulder joint is a ball and socket joint and is the most mobile joint in the body.  There are many muscular attachments to move the shoulder, therefore it’s very easy for muscle problems to develop.  Pain in the shoulder can refer to the arm, to the front of the chest, into the back, or up into the neck.  Acute shoulder problems usually last from a few days to a few weeks while chronic shoulder problems can last from a few weeks to many months.  More than half of shoulder problems resolve in 8-12 weeks, but 40% become chronic for longer than a year’s duration.  

Poor posture is a common cause of shoulder pain, as rounded forward shoulders increase stress on the shoulder joints.  Other common causes include repetitive stress movements on the shoulder, osteoarthritis of the shoulder joint, and traumas – like accidents and falls.

 
 

Many times, people believe they have shoulder pain when the actual cause is from their neck.  It’s very common for neck problems to refer to the shoulder.  A thorough exam and X-rays are always required to find the source of the problem

Sometimes shoulder pain can be due to misalignment of the shoulder joint.  This problem will not subside until it is addressed.  Chiropractors specialize in misalignments of the shoulder joint.  Finding the root cause is essential to properly treating and managing any shoulder pain.

 

How We Treat Shoulder Pain In Jackson, NJ

Comprehensive Consultation and Exam

In order to determine the cause of any shoulder problem, we must do a thorough consultation and examination.  First, we must take a detailed history to determine what past traumas or injuries might have been sustained that would give rise to shoulder problems.  We will need to see what other treatments were administered and what past therapies you’ve done.

Next, we will do a thorough examination which will include chiropractic, palpation, range of motion, and orthopedic evaluation.  We will also do a postural examination to see if abnormal posture is contributing to the shoulder pain.

Based on what we find in our consultation and examination, we can find the root cause of the problem and put together an appropriate treatment plan to work toward correcting your shoulder problem.

 
 

Digital X-rays

In order to really see what’s happening in the shoulder joint, we will take digital X-rays.  Often X-rays of the neck are taken to rule out the cause of the shoulder pain originating in the neck.  It’s important to visualize the spine and the shoulder joint to rule out other pathology like arthritis or degeneration of the shoulder joint.  

If it’s determined through X-ray and detailed examination that it’s not an issue with the actual bone structures of the shoulder, it may be necessary to refer you out for an MRI to visualize in more detail the soft tissue anatomy of the shoulder joint, like ligaments, bursa, or rotator cuff muscles or tendons.

 
 

Specific Chiropractic Care in Jackson, NJ

Multiple joints make the “shoulder joint”.  There is the glenohumeral joint (the actual ball and socket joint), the acromioclavicular joint (where the distal end of the clavicle makes a joint with the acromion), the sternoclavicular joint (where the proximal end of the clavicle articulates with the sternum), and the scapulothoracic joint (where the scapula moves with the ribs of the thorax).  Pain or injury can happen at any of these joints, that’s why when patients present with shoulder pain it’s important to identify what part of the shoulder is the problem.

Chiropractors can identify the particular joints that are restricted, not moving well, or, what we call, subluxated.  Once identified, we can appropriately adjust the joint to restore proper motion and alleviate pain and discomfort.

 

Massage Therapy and Soft Tissue Work

Before any adjustments to the spine or shoulder joints, it’s important to loosen up any tight muscles to support the proper movement of the shoulder.  Each doctor utilizes their own methods of massage or trigger point therapy to work the soft tissues.  At Kinney Chiropractic, we also have a massage therapist on staff – by appointment only – who can work additionally on the muscles around the shoulders to decrease muscle tension and pain.  The cause of the pain could be a pulled muscle, a joint restriction or subluxation, or something worse. 

 
 

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Common Causes of Shoulder Pain in Jackson, NJ

Frozen Shoulder

Frozen shoulder syndrome or, adhesive capsulitis, is a very common cause of shoulder pain.  This is where the capsule around the ball and socket joint of the shoulder becomes injured and sustains inflammation over time.  Frozen shoulder may start after a medical condition that doesn’t allow you to move your shoulder like a mastectomy, fracture, or stroke.  Sometimes it begins as an acute injury to the rotator muscles of the shoulder where the person does not move their shoulder because of pain.  

There are three stages of symptoms.  The first phase is the freezing phase.  This is where any movement of your shoulder causes pain and your shoulder’s range of motion starts to become limited.  The next phase is the frozen phase.  Pain may begin to diminish during this stage, however, your shoulder becomes stiffer and using it becomes more difficult.  The last phase is the thawing phase.  This is where the range of motion in your shoulder begins to improve.  

It’s important to put the shoulder through its entire range of motion and do exercises to improve shoulder mobility not only in the office but also at home.

 

Osteoarthritis

Another common cause of shoulder pain is osteoarthritis.  This is when years of wear and tear on the shoulder joint affect the cartilage, or shock absorbers, in the joint.  When cartilage breaks down this can affect the overall joint health.  

Symptoms of osteoarthritis include stiffness, tenderness, swelling, loss of motion, or sharp pain with certain motions.  Often there can be bone spurs in the joint when there is arthritis which acts like little spikes or thorns that can cut into the muscle with certain motions. 

Risk factors of arthritis include advanced age, obesity, past shoulder injuries, or repeated stress on the joint with sports or manual labor.   Although shoulder arthritis cannot be reversed symptoms can be managed.

 

Rotator Cuff Injury

Injury or tears to the rotator cuff are very common in shoulder pain.  The rotator cuff is made up of four small muscles that anchor and support the shoulder.  The muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis.  Rotator cuff injuries are common in sports like baseball, contact sports, or accidents or injuries where you fall on your shoulder.  They are also sustained with overuse injuries or manual labor.  The older a person is the more likely they are to sustain injury. 

To diagnose a rotator cuff injury, it’s important to take a thorough history and perform a detailed exam.  A full diagnosis of a rotator cuff injury is usually confirmed with an MRI.  If there is a torn rotator cuff, the patient will likely need physical therapy and perhaps steroid injections.  If the tear is very severe, the patient may need surgery.

 

Sprain or Strain

A common cause of shoulder pain is a sprain or strain injury.  The shoulder can sustain a strain and a sprain, there is a difference.  A strain is when the muscles and tendons around the shoulder joint get stretched or torn and give rise to pain.  A tendon is what connects muscles to the bone.  A sprain is when the ligaments become overstretched or torn. 


Ligaments are what connect bone to bone.  Sprains and strains usually occur with overuse, accidents, or injuries. 

Signs of sprains and strains include pain, swelling, and sometimes bruising.  Usually, there is a loss of mobility.  The patient may report hearing or feeling a pop in the shoulder when there is a sprain or strain injury.

When treating a sprain or strain to the shoulder, we use the R.I.C.E. approach to treatment.  Rest is always the first recommendation.  You don’t want to continue to use the shoulder or you will risk further injury.  Ice is always recommended over heat.  Ice is the best thing to use to minimize swelling and inflammation of the shoulder joint when there is an injury.  Compression is very helpful in a sprain or strain injury.  We recommend an ace or compression bandage and a sling to prevent motion.  Lastly, elevation is useful to prevent further swelling.  Sleeping elevated or propped up on pillows, and resting with the upper body elevated, is best with shoulder injuries.

 
 

Frequently Asked Questions

Can chiropractors help with shoulder pain?

Yes.  Chiropractors are very good at treating shoulder pain.  Once we identify the cause, we use a drug-free approach to decrease pain and improve mobility. 

Why is my shoulder pain not going away?

Shoulder pain that does not go away is a sign that there may be something more serious happening in the joint.  It’s important to have a chiropractor perform an exam and take X-rays to determine the cause of your shoulder pain.

What could shoulder pain be a sign of?

Shoulder pain could be many different things.  There may be a sprain or strain injury, osteoarthritis, a pinched nerve in the neck, or something worse.  It’s important to have your shoulder evaluated to determine the cause.

How should I sleep with shoulder pain?

It’s recommended to sleep on your back with your arm and shoulder elevated with a pillow when you have shoulder pain.

What can cause shoulder pain without an injury?

Shoulder pain is usually caused by some type of overuse or repetitive stress.  People who work manual labor, do heavy lifting or repetitive motions usually sustain shoulder problems without there being a specific injury.