Shoulder Pain Treatment

Motion at the shoulder depends on both the glenohumeral joint (the shoulder) and the scapula (shoulder blade) working together to move the arm. If either the glenohumeral joint or the scapula is restricted, either from tight musculature or joint dysfunctions, it will likely lead to overuse injuries on the supporting structures of the shoulder—most commonly the rotator cuff. 

The pain is often due to tendons getting pinched and muscles being overloaded, and so the body tries to reduce movements to prevent injury. If we continue to move with poor-quality motion, it will likely lead to some form of shoulder injury—rotator cuff tendinopathies and tears, bursitis, etc. 

In order to prevent progression, the limited structure in the shoulder’s motion must be identified, and healthy movement patterns must be achieved and maintained. This will allow the shoulder complex to function as it should and get you back to pain-free living.

Pinching in the shoulder is often a result of structures getting stuck. The tendons and ligaments are meant to slide past each other and slide through grooves in the bones of the shoulder joint. However, if the shoulder blade or arm isn’t moving well, this can alter the path of motion at the shoulder and result in a pinching sensation, as tendons and ligaments get “stuck” between bony structures. 

The best solution to pinching in the shoulder blade is to identify what’s not moving well and correct it so that the tendons can slide as they should.

A pinched nerve in the shoulder is most likely the result of compression on a nerve that supplies the shoulder. This compression can be coming from the neck or from muscles in the shoulder itself. It can be an incredibly painful experience, with sharp and shooting pain in your arm and numbness or tingling that accompanies that pain. 

If the compression is originating from the neck, it could be the result of a disc bulge or herniation, or bony changes in the vertebrae that press on the nerves. 

Muscles, either at the neck or in the shoulder can also create compression on the nerves when they’re tight, which can cause similar symptoms as a disc or bony protrusion, but often in slightly different areas. It’s a healthcare practitioner’s job to identify if the pain you’re experiencing is from a pinched nerve or from some other cause. Identifying the source of pain is important to focus treatment on the root cause.

The rotator cuff is a group of four small muscles that originate on the shoulder blade and connect to the humerus (bone of the upper arm). As a group, they function to control the motion of the arm at the shoulder joint, guiding the bones as they move and creating compression of the arm into the shoulder socket to stabilize the movement. 

They are incredibly important muscles and are prone to being overloaded when the “big movers” of the arm (the muscles actually responsible for creating the motion) don’t function properly and thus don’t create uniform motion. This overloading of the rotator cuff can lead to impingement, tendinopathies, or tears, depending on the severity. 

It’s important that a healthcare practitioner assess the motion of the shoulder complex to ensure that the rotator cuff can function as it should without increased load from compensation patterns.

The nerves that supply the muscles around the shoulder and the joints (that make up the shoulder complex) originate from the neck. Furthermore, many of the muscles surrounding the neck, like the levator scapulae and trapezius (the traps), attach to the shoulder blade. Because of these connections, tension in one area or irritation to the nerves that supply that area can create tension and pain in the other. 

Poor posture also usually involves both the neck and the shoulder, and so do many injuries to the area. It’s difficult to only injure the neck or shoulder without also injuring the muscles that connect the two. And so single events can affect both the neck and the shoulder, and you may experience pain in one area when moving the other.

Motion at the shoulder depends on both the glenohumeral joint (the shoulder) and the scapula (shoulder blade) working together to move the arm. If either the glenohumeral joint or the scapula are restricted, either from tight musculature, or joint dysfunctions, it will likely lead to overuse injuries on the supporting structures of the shoulder—most commonly the rotator cuff. 

The pain is often due to tendons getting pinched and muscles being overloaded, and so the body tries to reduce movements to prevent injury. If we continue to move with poor-quality motion, it will likely lead to some form of shoulder injury—rotator cuff tendinopathies and tears, bursitis, etc. 

In order to prevent progression, the limited structure in the shoulder’s motion must be identified, and healthy movement patterns must be achieved and maintained. This will allow the shoulder complex to function as it should and get you back to pain-free living.

A Chiropractor may treat your back for shoulder pain because the spine, particularly the cervical (neck) and thoracic (upper back) regions, is closely connected to the shoulder through nerves, muscles, and other soft tissues. Because of these connections, tension in one area or irritation to the nerves that supply that area can create tension and pain in the other. 

Poor posture also usually involves the neck, upper back, and shoulder, and so do many injuries to these areas. It’s difficult to injure the upper back or shoulder without also injuring the muscles that connect the two. Single events can affect both the upper back and the shoulder, and you may experience pain in one area when moving the other.

Because of this, whenever a person has shoulder pain, their back should also be evaluated, as dysfunction in those areas can lead to pain in the shoulder. The back may not be the source of pain, but it can absolutely be the cause.

Bursitis is inflammation of the bursa, which are small, fluid-filled sacs that reduce friction in areas with lots of motion, like the shoulder or the hip. When the joint itself is not moving well, it can put increased pressure on the bursa, which can then lead to bursitis. 

The common symptoms of bursitis are swelling, heat, pain, and limited motion in the joint in question. To treat bursitis, we need to address the underlying factors that caused the inflammation, as well as help the body reduce the inflammation with techniques like low-level light therapy, shockwave therapy, or ice.

A rotator cuff tear refers to either a partial tear in the tendon of a muscle of the rotator cuff or a complete rupture of the tendon. Complete ruptures are often treated surgically, but partial tears will often respond well to conservative treatment. 

A rotator cuff tear can occur suddenly, from a direct injury to the shoulder or from lifting a heavy object, but it often develops over time from repetitive movements with poor mechanics. Diagnosis of a rotator cuff tear includes a physical examination with orthopedic tests and sometimes imaging of the muscles and tendons to visualize the tear and assess the severity of the injury.

A tendinopathy is an injury to a tendon that usually develops over time. When a tendon is damaged and undergoes inflammation, this fails to resolve the issue, and the tendon fails to heal. The inflammation stops, and the tendon injury progresses. Some symptoms include pain with movement or when the tendon is being used, tenderness and swelling, decreased range of motion, and weakness in the muscle. 

Tendinopathies respond best to restarting the inflammation cycle with therapy like Shockwave, combined with appropriate loading to the area, to build strength around the weakened area of the tendon. This loading often requires movement repatterning so that a person does not continue to use the suboptimal movement patterns that led to tendinopathy in the first place.

Whether your shoulder pain can be fully resolved before starting to play sports depends on the underlying cause and severity of the condition. In some cases, conservative treatments such as rest, ice, physical therapy, massage therapy, and Chiropractic care may help alleviate shoulder pain and improve function, allowing you to return to sports relatively quickly. It’s essential to consult with a healthcare professional, such as a Chiropractor, for a proper evaluation so they can provide guidance on the most appropriate course of action and help you determine when it’s safe to resume sports activities.

Pins and needles in the hand can result from nerve compression or irritation originating from the shoulder. Conditions like cervical radiculopathy or thoracic outlet syndrome may cause both shoulder pain and hand symptoms. Muscle tension in the shoulder can also contribute to nerve compression. 

Chiropractic care may help by addressing nerve compression and restoring spinal and shoulder alignment. Typically, when your shoulder is not sitting in the proper position, it can lead to compression being placed on the nerve passing through the area, which leads to a tingling sensation in the hands. Muscles such as your upper traps, scalenes, and pectorals are common tight muscle groups that can lead to these symptoms.

Shoulder pain when sleeping on it can stem from various causes like rotator cuff issues, impingement syndrome, frozen shoulder, bursitis, arthritis, or poor sleeping position. To alleviate discomfort, try sleeping on your back or the opposite side, using supportive pillows or specialised shoulder pillows. 

Addressing underlying shoulder issues through Chiropractic care, physical therapy, massage therapy, and lifestyle changes can also help improve shoulder function and reduce pain.

Frozen shoulder, also known as adhesive capsulitis, is a condition characterised by pain and stiffness in the shoulder joint. It typically develops gradually over time and progresses through three stages: freezing, frozen, and thawing. 

During the freezing stage, pain and stiffness gradually increase, limiting shoulder movement. In the frozen stage, pain may decrease, but stiffness remains severe, significantly restricting shoulder mobility. Finally, during the thawing stage, shoulder movement gradually improves, and symptoms begin to resolve. 

The exact cause of frozen shoulder is not fully understood, but it may result from inflammation, scar tissue formation, or changes in the shoulder joint capsule. Risk factors for frozen shoulder include age, gender (more common in women), some medical conditions, and shoulder injury or surgery. 

Chiropractic treatment may include adjustments to the spine and shoulder, soft tissue therapy, and rehabilitative exercises to improve shoulder mobility and function.