Your shoulder pain symptoms may be caused by a variety of reasons.
It is vital to the successful outcome of your chiropractic treatment, to
find the underlying cause of your symptoms.
Your shoulder pain may as a result of an injury to any of the tissues of the neck and
shoulder, including muscles, nerves, joints, tendons, connective tissue or
reduced blood supply. The area or spread
of symptoms may involve the whole shoulder or may only affect specific areas of
the shoulder. The symptoms may be
constant or intermittent and may improve or worsen with motion.
Common symptoms of the shoulder
may include: pain, pins and needles, decreased mobility, weakness or stiffness.
The type of pain / symptoms may be
described as burning, dull, sharp or throbbing.
These symptoms may range in intensity from mild to severe. Frequently, symptoms perceived in the shoulder
are actually referred from a lesion in the neck and vice versa.
Here is a selection of
common injuries that have been diagnosed at this clinic.
Shoulder impingement syndrome is a common cause of shoulder and
upper arm pain. The ‘rotator cuff’ is a
group of posterior shoulder muscles that stabilize the top of the humerus (arm)
into the shoulder socket. When these
muscles become weakened and lose their ability to stabilize the shoulder
complex, the tendons of these muscles (particularly the supraspinatus tendon)
are liable to be compressed / sandwiched between the bony acromion process and
top of the humerus.
This rotator
cuff tendonitis may occur in isolation or may be in combination with
inflammation of the shoulder bursa (bursitis), culminating in shoulder
impingement syndrome. Sometimes, the
term ‘frozen shoulder’ is inappropriately used to name this condition.
The subsequent
inflammation of these tissues results in swelling and increased symptoms or
pain and immobility. The symptoms are
often described as a ‘toothache’ type of pain and abduction of the arm above
shoulder level and hand ‘up the back’ becomes increasingly difficult. Hence, reaching for high selves and fastening
bra straps exacerbates symptoms.
Although
this condition can happen at any age, it becomes more of an issue as we get
older. The rotator cuff tendons
degenerate and are less likely to heal, as they once did, resulting in total or
partial tendon tears.
A tendonitis
of the biceps tendon may also give similar symptoms and mobility issues. Occasionally, X-rays may be required to rule
out osteoarthritis and sub-acromial spurs.
A good
diagnosis is the first step to alleviating your symptoms. Once this has been achieved, then the
appropriate treatment and rehabilitation exercises may be given.
Myofascial Pain Syndrome comes from the words ‘myo’ which
means muscle, and ‘fascia’ which is the connective tissue that covers all
muscles and organs of the body. You will
have no doubt heard of a ‘knot’ in a muscle and most probably experienced some
‘tension’ in a muscle or group of muscles.
Myofascial pain, often referred to as ‘trigger points’, are points of hyper-tension (knot) within a band
of tense muscle fibres. These trigger
points can be either ‘active’ or ‘latent’, which indicates whether or not they
refer pain to distal sites or not.
Active
trigger points in the muscles of the upper shoulder girdle may refer pain and
pins and needles into the neck and arm, depending on where the trigger
points are located. When these active
trigger points are further stressed by poor posture, sustained contraction,
cold / hot weather, then they may refer symptoms to their predictable site.
Latent
trigger points do not refer symptoms but do cause local pain. These latent trigger points will evolve into
active trigger points if left untreated and if the original stress continues.
A
diagnosis, treatment and rehabilitation is required to de-activate these
trigger points which will alleviate the symptoms.
A Slipped Disc in the cervical spine (neck) may
refer pain and symptoms into the shoulder, due to compression or chemical
irritation of the cervical nerve from the adjacent ‘bulging’ or herniated
cervical disc. The cervical nerve is
‘irritated’ by the slipped disc as it exits the cervical spine, before it
courses down the neck.
It may
produce symptoms of pain, pins and needles and/ or numbness and is often called
‘radicular’ pain or a ‘radiculopathy’.
The symptoms are often described as ‘shooting’ or ‘throbbing’ pains and
symptoms may increase when you cough or sneeze.
Surgical intervention is sometimes required, to reduce the nerve
compression.
Another
cause of a ‘radiculopathy’ is osteoarthritis of the cervical spine. In this case, the exiting cervical nerve is
trapped by the surrounding bony cervical vertebrae, commonly found in people
with degeneration (wear and tear) of the neck joints. This diagnosis is not amenable to
chiropractic intervention.
It is absolutely
paramount to your good health that the underlying causes of your shoulder symptoms
are found and correct diagnosis is made. Dr Doherty will use his wealth
of experience to achieve this and to make the appropriate management plan for
you.
Similar symptoms are not
always as a result of similar causes. The consultation and examination
will differentiate between the many causes that may be producing your shoulder symptoms.