According to the American Academy of Orthopedic Surgeons (AAOS), frozen shoulder occurs in about 2 percent of the general population.
It most often affects adults between the ages of 40 and 60, and is also more commonly seen in women than in men.1 Frozen shoulder, sometimes known as adhesive capulitis, occurs when the shoulder becomes stiff, painful, and either difficult or unable to move.
By the time many of these patients come to the DC’s office, they have likely already been to an orthopedist’s office. The orthopedist’s treatment may have been ineffective, so the patient is probably seeking a second opinion. In other cases, the orthopedist may have recommended surgery, so the patient could be looking for a noninvasive alternative treatment. In either case, the DC is in an excellent position to restore full range of motion to a frozen shoulder.
What causes frozen shoulder?
The shoulder is a ball and socket joint, consisting of the humerus (upper arm), scapula (shoulder blade), and clavicle (collarbone), along with the surrounding muscles, ligaments, and tendons. The head of the humerus fits into a socket in the scapula, and the surrounding connective tissue is called the shoulder capsule.1
In a case of frozen shoulder, the connective tissue forming the shoulder capsule becomes thick and tight. Tough bands of tissue, called adhesions, develop and there may also be a loss of synovial fluid, which is designed to lubricate the joints. As these adhesions thicken, the shoulder becomes more and more difficult to move, even with help.1
Although no clear cause for frozen shoulder has been established, it is thought to be more common if the arm has been immobilized for a long period of time, such as following surgery or an arm fracture.2
Standard treatments for frozen shoulder
Standard treatments range from over-the-counter pain medications, to physical therapy, to steroid injections.1–2 In severe cases, surgery to loosen or remove the adhesions in the shoulder capsule may be recommended. Patients are also encouraged to move the affected shoulder as much as possible in order to prevent further damage.
Chiropractic treatment for frozen shoulder
Similar to physical therapy, the DC will move the shoulder through its full range of motion and then compare that to what the patient can do without assistance. This allows the DC to understand exactly where the shoulder is stiff or frozen. 1–2 Instrument adjusting is particularly well suited to treating shoulder issues, as it can transmit more thrust with less force to the small area of the shoulder capsule than can be done with a manual adjustment. This makes treatment less painful for the patient while yielding better results.3
A good example of the benefits of instrument adjusting for frozen shoulder is a case report written up in the February 1995 issue of the Journal of Manipulative and Physiological Therapeutics. A 53-year-old woman who had suffered from frozen shoulder for six months underwent a variety of unsuccessful standard treatments, including pain medication and physical therapy. Her shoulder was almost completely immobile. Several instrument adjustments were performed on the shoulder and the cervicothoracic region of the spine. Following several instrument adjustments, the patient regained the range of motion in her affected shoulder. The author concluded: “Chiropractic care may be able to provide an effective mode of therapeutic treatment for certain types of these difficult cases. Low force instrumental adjustments, in particular, may present certain benefits in these cases that the more forceful manipulations and/or mobilizations cannot.”4
Patients who have been diagnosed with frozen shoulder may feel as though invasive procedures, such as steroid injections or surgery, are their only option. However, instrument-assisted chiropractic care may be just what is needed to thaw out those frozen shoulders.
1 Widmer B. “Frozen shoulder.” American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00071. Reviewed January 2011. Accessed January 2015.
2 Mayo Clinic Staff. “Frozen shoulder.” Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/frozen-shoulder/basics/causes/con-20022510. Published April 2011. Accessed January 2015.
3 Stewart D. “Instrument adjusting shoulders.” Chiropractic Economics. https://www.chiroeco.com/news/chiro-article.php?id=15348&catid=776&title=instrument-adjusting-shoulders. Published July 2014. Accessed January 2015.
4 Polkinghorn BS. “Chiropractic treatment of frozen shoulder syndrome (adhesive capsulitis) utilizing mechanical force, manually assisted short lever adjusting procedures.” J Manipulative Physiol Ther. 1995:18(2);105–115.