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Frozen Shoulder (Adhesive Capsulitis)
In our chiropractic clinics we often find the term 'frozen shoulder' misused. The term is commonly used to describe any persistent shoulder pain and restricted movement. Shoulder problems can be complex and require a thorough assessment to be accurately diagnosed and as with any other joint problem, the success of any treatment depends on correct diagnosis and cooperation between patient and practitioner.
This page has been designed to clarify some common misconceptions of shoulder problems seen in chiropractic practice.
Frozen shoulder refers to loss of arm movement at the shoulder joint combined with inflammation of the tissues within the joint capsule that surrounds the shoulder. These tissues become thickened and shortened and eventually 'stick' together, hence the medical term - adhesive capsulitis.
Initially, there is progressive limitation of all movements of the shoulder. This may follow a recent minor trauma, dislocation, prolonged immobilization, heart attack (myocardial infarction) and sometimes neck problems (cervical radiculitis). Pain may or may not accompany this, although pain will be felt if you try to exceed the limited movement. This stage is sometimes referred to as the 'freezing' stage. Eventually, the condition progresses until all movement is greatly restricted - 'frozen' stage. Usually, no pain is felt at this stage. The reverse of this process occurs during recovery, when pain is again experienced but once movement is restored, the pain diminishes. Early diagnosis is vital because the condition is reversible. Once it has progressed into the adhesive/frozen stage, some persistent restriction may remain. The recovery period varies depending on how long the problem has been there and the severity of it.
The rotator cuff muscles play an important role in the movement of the shoulder. They consist of the supraspinatus, infraspinatus and teres minor muscles. The rotator cuff tendon is a major source of pain and disability. If it becomes inflamed (tendonitis) or torn; voluntary abduction, elevation and rotation of the shoulder is lost. However, the chiropractor will be able to move the shoulder noting only a slight loss in movement due to pain. Whereas with frozen shoulder, the chiropractor will not be able to move the joint. Rotator cuff muscle pain is usually due to trauma or overuse movements.
Bursas are fluid filled sacs that surround certain joints of the body and act to prevent excess friction between tissues and/or bony surfaces. In the shoulder, you will find the sub-deltoid bursa that lies underneath the deltoid muscles. (These muscles make the rounded shape of the shoulder/arm). The bursa can become inflamed or pinched which in turn will produce pain and some limited movement of the shoulder. Slight swelling and heat production may be felt.
When joints become fixated and irritated in the neck, pressure may occur on the surrounding nerve fibres. These nerves supply information to the muscles of the shoulder and if these nerves become inflamed, the muscles go into spasm and weaken, and subsequently movement will be affected. Chiropractic treatment can help this condition. Call Dr. Pisarek for your shoulder assessment.
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I have been a patient of Dr. Pisarek for a few years now. Every morning I have to say "thank you Dr. P.!". Your care and your treatment renew my energy... no more pains in my lower back, knee and foot. With your help I lost 20 pounds and I am keeping it off. I am really grateful to you and your wife Hilda for taking care of me. My retirement got a new meaning, thanks to you.