Conditions

Shoulder Pain

Shoulder pain can be caused by trauma, repetitive strain, and even postural strain, to the muscles, ligaments, tendons, nerves, and joints of our shoulder. The shoulder is also an area where referred pain from the neck can occur. Around 16% of people experience shoulder pain daily, with some being acute episodes ranging from a few days to a few weeks, with others ranging from weeks to months, and even years.

The most common cause of shoulder pain is from the muscles of the shoulder and shoulder blade, mainly the rotator cuff. Often these muscles are strained or torn throughout the various activities we perform. Sometimes they can be become very deconditioned from lack of use, and are easily strained when attempting something we have not done for some time. Another common shoulder pain from the rotator cuff is shoulder impingement, where symptoms are caused by the rotator cuff but caused by function of the shoulder blade.

Other shoulder conditions include AC joint pain, adhesive capsulitis (frozen shoulder), biceps tendinitis & tendinosis, and bursitis.

Shoulder pain is a frequent and common conditions that Chiropractors who work with athletic populations treat. These conditions benefit from a combination of hands-on therapies for pain management, combined with exercise therapy to re-strengthen weak areas or change shoulder mechanics in the long-term.

Shoulder pain doing pull up on ring Chiropractic assessment

Causes of Shoulder Pain

Pain coming from the rotator cuff group of muscles. This can be a grade 1-2 strain, or a full tear in the case of grade 3. Syndrome refers to the general group of possible rotator cuff disorders.
The cuff is a group of 4 muscles that attach from our shoulder blade to our shoulder. They are most active when our arm is away from our side, and help to stabilize our shoulder and prevent dislocations.
Rotator cuff pain can be sharp and pinpoint, or achy and diffuse. It can be felt with specific movements (depending on which muscles are involved), and is often felt when sleeping on your side at night. Sometimes it radiates down your arm as an achy and deep pain.
A weak rotator cuff is common with disuse, previous strains, and poor shoulder function. Rotator cuff issues often lead to pain in the rotator cuff itself, and increase risk of shoulder dislocation.
Shoulder impingement happens when the rotator cuff muscles and tendons get trapped underneath the bony parts of our shoulder girdle. This is most often because of poor shoulder girdle mechanics.
Shoulder impingement and rotator cuff syndrome can overlap in how they feel, but a key difference in impingement is reduction or resolution of symptoms when modifying shoulder blade mechanics. In these situations, proper hands-on therapy and exercise therapies to the muscles not functioning properly leads to resolution of the problem.
As experts in assessment of posture and muscle function, Chiropractors that work with sports injuries are experts at treated this and other shoulder conditions.
Our acriomioclavicular joint (AC joint), sits just above and toward middle of our shoulder joint (glenohumeral joint). This joint is often sprained with falls on an outstretched hand, or on the side of our shoulder with our arm at our side.
The AC joint can be sprained, but pain can also come from the joint itself.
AC joint pain can be difficult to diagnose, and is a common source of ongoing shoulder pain that has not responded to other therapies. Treatment involves trying to optimize shoulder girdle mechanics to support the joint, and modifying shoulder posture and function to help to do the same. Some gentle joint and muscle therapies can be used to help relieve symptoms.
AC or Frozen Shoulder is a type of shoulder pain that can come on very suddenly, sometimes after trauma or having been immobilized. The mechanism of onset is not well understood by researchers compared to other issues.
Usually the condition involves a sudden and severe limitation in shoulder mobility due to pain and restriction. Because the mobility restriction is so severe, this condition can be life altering and have a huge impact on our work, sport, and home responsibilities.
Treatment involves a gradual process of building back mobility, first with assisted exercises where the affected side is relaxed, then to active mobility and later strengthening if needed. Though hands-on treatment can help symptoms, exercise therapy tends to be a better long-term aid to frozen shoulder.

Biceps tendinitis is an acute episode of inflammation to the biceps tendon located at the shoulder (not the elbow attachment). This is usually after repetitive use at volumes higher than the area is used to, or from a sudden elastic pull on the tendon.
Biceps tendinosis is a more chronic episode of degeneration and unhelpful remodeling of the biceps tendon after repetitive episodes of biceps tendinitis and irritation.
Biceps tendinitis can respond very well to hands-on treatment and usual tendinitis treatments, while tendinosis is more difficult to treat. Tendinosis treatment involves hands-on therapy for relief plus a graded rehabilitation program to remodel the tendon architecture.
Chiropractors that work on sports injuries are well suited to both assess and treat biceps tendinitis and tendinosis with hands on therapies and exercise therapies.
Shoulder osteoarthritis (OA) refers to arthritis in the main shoulder joint, the glenohumeral joint. Though conservative treatment does not cure or fix the arthritis, it is able to provide symptom relief to the local muscles and joint. A major goal is to optimize shoulder function by strengthening the muscles of the shoulder girdle and shoulder, and to find ways to modify movements and postures to best support the joint and increase quality of life.
Pain in the shoulder blade, shoulder girdle, or the shoulder is common to experience from a neck issue. Neck muscles, joints, and nerves can often “refer” or radiate pain to the shoulder, and even down the arm.
If you have a shoulder issue that is not responsive to local shoulder treatment, and you also have neck symptoms and functional issues, than consider the possibility of shoulder pain being referred form the neck.
Chiropractors are able to perform assessments to determine whether the cause of shoulder pain is local, or from another source like the neck.