A chiropractor specializes in the diagnosis and conservative management of conditions affecting the musculoskeletal system, including joints, muscles, and nerves. Significant pain and stiffness in the shoulder may indicate frozen shoulder, or adhesive capsulitis. This condition severely restricts the shoulder joint’s range of motion, making everyday activities difficult. This article explores the role of chiropractic care in addressing this condition and helping patients regain mobility.
Understanding Adhesive Capsulitis
Adhesive capsulitis is a disorder characterized by the thickening and tightening of the joint capsule, the connective tissue surrounding the shoulder joint. This capsule encases the ball-and-socket joint, providing stability. In frozen shoulder, the capsule becomes inflamed and contracts, often accompanied by reduced lubricating synovial fluid within the joint.
The condition progresses through three distinct, overlapping stages. The initial “freezing” stage involves increasing pain and a slow loss of motion, lasting two to nine months. This is followed by the “frozen” stage, where pain may lessen, but stiffness maximizes, limiting function for four to twelve months. Finally, the “thawing” stage sees a slow, spontaneous return of movement and function, which can take five months to two years to complete.
Chiropractic Evaluation and Treatment Objectives
Chiropractors begin with a thorough physical examination and differential diagnosis to confirm adhesive capsulitis and rule out other causes of shoulder pain, such as rotator cuff tears. This assessment includes observing posture and performing specific orthopedic tests to gauge both active (patient-initiated) and passive (doctor-assisted) range of motion. The hallmark of frozen shoulder is a marked reduction in both active and passive movement, particularly external rotation.
Management goals shift depending on the patient’s stage. In the painful “freezing” stage, the focus is managing pain and inflammation without aggressive stretching that could cause irritation. As the condition moves into the “frozen” and “thawing” stages, the objective shifts toward gradually restoring active and passive range of motion. Treatment is individualized, aiming to improve joint mobility while decreasing discomfort.
Manual Therapy Approaches for the Shoulder
Chiropractors employ various techniques to address the restricted shoulder joint capsule and surrounding tissues. Gentle joint mobilization is a primary technique, involving small, controlled movements within the joint’s current limit of motion. This controlled movement encourages the joint capsule to stretch and helps break up the adhesions that cause stiffness. Soft tissue work is also used extensively on the muscles surrounding the shoulder, which is often held in a guarded position.
Techniques like myofascial release, trigger point therapy, and therapeutic stretching are applied to the muscles of the chest, shoulder blade, and upper arm to relax tension and improve flexibility. Additionally, a chiropractor may use low-force adjustments to the upper back (thoracic spine) and neck (cervical spine). Addressing these adjacent spinal segments is important because spinal stiffness can negatively impact the biomechanics and function of the shoulder joint.
Realistic Recovery Timelines and Adjunctive Care
Frozen shoulder is a self-limiting condition, meaning it will resolve on its own, but the process is lengthy, often taking 12 to 18 months even with conservative care. Chiropractic care aims to accelerate this natural resolution, reduce pain intensity, and maximize the eventual return of function. Success is measured by quantifiable improvements in the ability to move the arm and perform daily activities, not just pain reduction.
Recovery relies heavily on patient compliance with a prescribed home exercise program. These exercises, typically involving gentle stretching and strengthening, must be performed consistently to maintain mobility gained during in-office sessions. If a patient shows no measurable progress after consistent chiropractic treatment, the chiropractor may refer them for adjunctive medical care. This might include consulting an orthopedic specialist for options like corticosteroid injections or, in rare cases, surgical manipulation under anesthesia.