Shoulder
Treating shoulder dysfunction and “frozen
shoulder”.
Ferguson LW. Chiropractic Technique, 1995; 7:73-81.
Author’s
Abstract:
This article presents three case histories to illustrate
the treatment of “frozen shoulder” and related
shoulder dysfunction as a combined disorder involving joint
dysfunction and myofascial pain syndrome. The author reviews
the literature and questions the traditional treatment approaches,
which focus on treating inflammation and breaking adhesions.
The concept of adhesive capsulitis as the only cause of “frozen
shoulder” is challenged. The author proposes an alternative
treatment protocol that addresses specific patterns of joint
dysfunction and myofascial disorder.
Comment by Dr. Koren: Dr.
Ferguson utilized spinal adjustments and shoulder adjustments.
Conservative
chiropractic care of frozen shoulder syndrome: a case study.
Freeley KM Chiropr Res J, 1992; 2(2):31-37.
Frozen shoulder,
also known as adhesive capsulitis is a complex of symptoms
including painful shoulder of gradual onset with slowly increasing
pain and stiffness and limitation of movement.
This is the case
of a 43 year-old woman suffering from neck pain radiating into
the left shoulder, arm and left dorsal area, with associated
severe muscle weakness of the left arm. The problem began 20
years ago with the birth of her first child. The patient also
suffered from headaches in the suboccipital region for the
prior 8-10 years, neck pain and thoracic pain on the left side.
The
patient was adjusted using upper cervical procedures. Immediately
after the first adjustment the left hand doubled in grip strength
as the right hand increased by 25%. Post x-rays showed correction
of the spinal distortions however, the symptoms took longer
to resolve.
One month after beginning care the patient reported
feeling “much
better” with full range of motion of the left shoulder
regained. Within 6 weeks the shoulder and arm pain had completely
resolved with a 400% increase in left hand grip strength
and a 100% increase in right hand grip strength. A one-year
follow-up showed continued resolution of her problems.
Comparison
of physiotherapy, manipulation, and corticosteroid injection
for treating shoulder complaints in general practice: randomized,
single blind study. Sobel JS, Winters JC, Groenier K, Arendzen
JH, Meyboom de Jong B. British Medical Journal 1997; 314:1320-5.
198
patients with shoulder complaints were divided into two diagnostic
groups: 58 in a shoulder girdle group and 114 in a synovial
group. Patients in the shoulder girdle group were randomized
to manipulation or physiotherapy and patients in the synovial
group were randomized to corticosteroid injection, manipulation
or physiotherapy.
In the shoulder girdle group, the duration
of complaints was significantly shorter after manipulation
compared to physiotherapy. The number of patients reporting
treatment failure was less with manipulation.
In the synovial
group, duration of complaints was shortest after corticosteroid
injection compared with manipulation and physiotherapy.
(Note:
either G.P.s or physiotherapists performed the manipulations).
Physical
examination of the cervical spine and shoulder girdle in patients
with shoulder complaints. Sobel JS, Winters JC, Groenier K,
Arendzen JH, Meyboom de Jong B Journal of Manipulative and
Physiological Therapeutics 1997; 20:257-62.
From the abstract:
In the population of patients without shoulder
complaints the mobility in the cervical and upper thoracic
spine was found to decrease with aging…functional disorders
in the cervical spine, the higher thoracic spine and the
adjoining ribs are not extrinsic causes of shoulder complaints,
but an integral part of the intrinsic causes of shoulder
complaints.
Copyright 2004 Koren Publications, Inc. & Tedd
Koren, D.C.