Shoulder pain is defined as chronic when it has been present for longer than six months.
Shoulder pain arises in or around the shoulder from its joints and surrounding soft tissues. Joints include the glenohumeral, acromioclavicular, and sternoclavicular joints. Bursae and motion planes include the subacromial bursa and scapulothoracic plane. Regardless of the disorder, pain is the most common reason for consulting a practitioner. In frozen shoulder (adhesive capsulitis), pain is associated with pronounced restriction of movement. Rotator cuff disorders may affect one or more portions of the rotator cuff and can be further defined as subacromial impingement (rotator cuff tendonitis), rotator cuff tear (partial/full thickness), or calcific tendonitis. A subacromial/subdeltoid bursitis may be associated with any of these disorders, or may occur in isolation. When selecting treatment options for shoulder pain a diagnosis of the specific pathology is rarely necessary. The most useful aspect of diagnosis is to define the source of pain as originating from the cervical spine, glenohumeral joint, rotator cuff, or acromioclavicular joint. A simple algorithm incorporating identification of red flag symptoms and signs, questions in the history, and simple shoulder tests can be followed to locate the source of the shoulder pain.
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Common causes of shoulder pain include:
- Rotator cuff tear
- Frozen shoulder
- Shoulder joint tear
The appropriate chiropractic treatment is unique to each shoulder pain and is directed at the primary dysfunctions detected during the chiropractic exam.