Frozen shoulder, medically known as adhesive capsulitis, severely limits shoulder movement. The shoulder joint capsule becomes thickened, tight, and inflamed. While many people turn to traditional medical treatments, others seek conservative options, and chiropractors manage this condition by restoring mobility and reducing discomfort through non-invasive methods.
Understanding Frozen Shoulder Stages
Frozen shoulder typically progresses through three distinct, overlapping stages. The first phase is the Freezing Stage, characterized by the gradual onset of pain that worsens over time, often lasting from two to nine months. During this period, the shoulder’s range of motion slowly begins to diminish as pain increases with movement.
The second phase is the Frozen Stage, where the pain may lessen but the stiffness becomes pronounced, making the shoulder difficult to move. This phase can last between four and twelve months, and the severe restriction in movement impacts daily activities. The final phase is the Thawing Stage, during which the individual gradually regains motion in the shoulder, which can take anywhere from five months up to two years.
Chiropractic Assessment and Care Philosophy
A Doctor of Chiropractic (DC) begins care with a thorough assessment to confirm the diagnosis and rule out other shoulder pathologies, such as a rotator cuff tear. The examination focuses on testing both active range of motion (patient movement) and passive range of motion (doctor movement). This process helps the DC identify the pattern of motion loss specific to adhesive capsulitis.
The philosophical approach centers on restoring proper joint biomechanics and reducing inflammation within the shoulder and surrounding structures. Chiropractors evaluate the entire musculoskeletal system, including the cervical and thoracic spine, to address nerve irritation or postural issues that may contribute to shoulder dysfunction. Treatment goals are tailored to the specific stage of the condition, focusing on pain management during the Freezing Stage and active mobility work later on.
Specific Manual Therapy Techniques
Chiropractors utilize several hands-on techniques to improve mobility and decrease stiffness. Joint mobilization involves gentle, controlled movements applied to the shoulder joint to reduce stiffness and encourage the breakdown of adhesions within the capsule. These techniques are applied progressively, respecting the patient’s pain levels and the current phase of the condition.
Soft tissue therapy is often incorporated to address the tension in the muscles surrounding the shoulder. Techniques like myofascial release, trigger point therapy, and Active Release Technique can help reduce muscle tightness and enhance blood flow to the area.
Targeted stretching protocols are a fundamental part of the treatment plan to increase flexibility and range of motion. The chiropractor guides the patient through specific exercises to gently stretch the joint capsule and surrounding muscles. Patient compliance with a regular home exercise program is important, as consistent stretching accelerates the recovery process and maintains treatment gains.
Determining When Referral is Necessary
While chiropractic care is beneficial, there are situations where a referral to another specialist is appropriate. A referral is necessary if a patient fails to show measurable improvement in pain or range of motion after a defined period of conservative care. Persistent and severe functional restrictions resistant to manual therapy may indicate the need for a more invasive approach.
Severe, unrelenting pain, especially at night, or the presence of “red flag” symptoms like unexplained swelling or sudden loss of active arm elevation suggest a need for further medical evaluation. These symptoms could point to other underlying conditions or require interventions such as corticosteroid injections or surgical options like manipulation under anesthesia. Chiropractors often work collaboratively with primary care physicians or orthopedic surgeons.