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Healing Chronic Shoulder Pain

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Chiropractic Care and Rehabilitation of Chronic Pain

Chronic injuries require specific rehabilitation and a long-term approach. Patience is required and it is important to recall that the problem has developed over the course of years and will not be fixed in a matter of weeks or months. Progress should be obtained in the short-term, but such situations usually require consistent, ongoing attention to achieve a long-term solution.

Performing the appropriate rehabilitative activities is critically important and chiropractic care can be of great assistance in getting the most out of your exercise program. Regular chiropractic care improves the mobility of your spinal column and removes nerve interference 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 nerve system, regular chiropractic care helps maximize your body's ability to recover from chronic injury.

As we get older, years and decades of mechanical stress may lead to deterioration of joints, ligaments, and tendons. This degenerative process, commonly known as arthritis, primarily affects weight-bearing joints such as the hips and knees and those found in the lumbar spine. The shoulder, too, is especially prone to undergo arthritic changes owing to its extreme mobility. The extensive range of motion at the shoulder is built-in to the design of this structure, but the tradeoff is instability. The design of the shoulder sacrifices stability for mobility.

Degenerative disorders of the shoulder typically involve the rotator cuff. This broad, flat structure is composed of the muscle-tendon units of the four rotator cuff muscles: the supraspinatus, infraspinatus, subscapularis, and teres minor. The thick covering of the rotator cuff surrounds the head of the arm bone and supports and strengthens the shoulder joint. But owing to the shoulder's inherent instability contrasted with its great mobility, the soft tissues of the rotator cuff undergo repetitive stress and strain. Ultimately, degenerative changes may occur, leading to the two prominent symptoms of pain and restricted range of motion.

An entire orthopedic sub-specialty focuses on treatment of chronic shoulder pain and includes long-term use of anti-inflammatory medication, corticosteroid injections when medications do not provide sufficient relief, and eventually surgery to repair tears in the various rotator cuff tendons. "Revision" surgery is commonly performed when the benefits of prior surgery are exhausted.1

The good news is that in many cases, a more optimal approach is available, one that utilizes the body's own natural recuperative powers. For many people, chronic shoulder pain can be reduced and chronic loss of mobility can be improved by engaging in specific activities and performing specific rehabilitative exercises. The goals of rehabilitation are to increase shoulder range of motion and build up shoulder strength. As these goals are accomplished, the likely result is reduction of intensity and frequency of occurrence of shoulder pain.

Engaging in an overall strength training program is an important general approach to managing chronic shoulder pain.2,3 Strength training should be done progressively, starting with light weights and building up over time. Exercises specific to the shoulder include seated dumbbell or barbell presses, dumbbell or cable lateral raises, seated bent-over rows, and internal and external rotation exercises done with very light dumbbells on a flat bench. If one has experienced an acute shoulder injury, early rehabilitation should precede rehabilitative strength training. Early rehabilitation includes pendulum exercises and finger-walking up a wall in both forward-facing and side positions.

Your chiropractor is experienced in injury rehabilitation and will be able to help you design an effective flexibility and strengthening program for improved shoulder function.

1Keener JD: Revision rotator cuff repair. Clin Sports Med 31(4):713-725, 2012
2Lewis JS: A specific exercise program for patients with subacromial impingement syndrome can improve function and reduce the need for surgery. J Physiother 58(2):127, 2012
3Andersen LL, et al: Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. Pain 152(2):440-446, 2011
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Testimonial

I'm a young and fairly active woman. I started having a pain in my hip area and thought it was a pinched nerve or something. This went on about once a month for about four months. The pain was getting stronger every time this would happen. The last time it happened the pain was so bad it put me into tears! I didn't want to go to a doc in the box because I figured they would just prescribe me pain pills and not fix the problem... whatever that would be. My Office Manager suggested that I go to Dr.Klena. She and the staff here at my new job all used him. Idaho Chiropractic got me in first thing in the morning and took good care of me. Come to find out it was from a previous car accident and when I had started playing golf four months earlier I was just irritating that hip and inflamed some tissue in that joint. Dr.Klena made a complete plan for me that included adjustments, ultra sounds, stretching and strengthening on top of a payment plan! I'm fixed and so grateful that they could do it without medicating me.

Thank you Dr.Klena and Staff!

Summer K.
Boise, ID


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