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.