|
Shoulder Problems
Why wait
in pain? Call now for an appointment.
Shoulder problems can be very
painful and debilitating but luckily are rarely
serious and in most cases amenable to treatment.
They can be roughly
split into five categories.
Frozen Shoulder Syndrome
(Adhesive Capsulitis)
Can be a very painful and debilitating condition
that presents as stiffness in all directions of
movement and pain around the shoulder that can
radiate to the upper arm, which can also be present
at night. It normally resolves within two to three
years without treatment.
The cause is unknown and can appear gradually for no
apparent reason but it may also be the result of
trauma, immobility or surgery. It mainly affects
those over the age of 40 and slightly more women
than men. If you have diabetes you are five times
more likely to suffer. It most commonly presents in
the non-dominant arm.
The early evidence for the use
of osteopathy is encouraging.
Osteopathic treatment for this condition usually
involves deep soft tissue techniques, articulation
and exercise prescription. This study compared
Osteopathy, Physiotherapy and placebo over a twelve
week period and involved 27 participants. It showed
a significant increase in range of movement and
reported decrease in pain by 80% for the osteopathy
group.
Increase in range of movement
Osteopathy 52.6 degrees of improvement
Physiotherapy 24 degrees of improvement
Placebo 0.8 degrees of
improvement
Improvement
in pain
Osteopathy 38.7 point improvement
Physiotherapy 19.9 point improvement
Placebo 22.8 point improvement
It is normally done over a period of approximately
two to three months. This significantly reduces the
usual recovery period of two to three years. More
work is needed before we can say categorically that
osteopathy can cure frozen shoulder but we are
encouraged.
A copy of the published
results can be found by clicking,
Here
There are usually three distinct phases.
1.
The Painful Phase
The shoulder gradually begins to ache
You may develop pain all round the shoulder, often
worse at night and when lying on the affected side.
This phase can last between 2-9 months without
treatment.
2.
The Stiffening Phase
Your pain will normally stay the same. However, the
stiffness starts to really affect your daily life
and
you may develop difficulty with normal daily
activity, such as dressing and working.
Muscle wastage may be evident due to lack of use.
This phase can last between 4-12 months without
treatment.
3.
The Thawing Phase
You should get a gradual increase in your range of
movement and decrease in your pain, although it may
change in nature as the range of movement increases.
This phase can last between 5-12 months.
Sub Acromial Impingement Syndrome
(Rotator Cuff)
This
is a condition that is mostly caused by the tendons
of four muscles, collectively called the rotator
cuff. The tendon gets impinged between the top of the humerus (arm bone) and the bottom of the acromium
process (part of the shoulder blade). It normally
comes on after an injury but can be from repetitive
micro trauma; especially if there is degeneration of
the acromio-clavicular joint which is at the end of
the collar bone. This can decrease the amount of
space for the tendon. Occasionally it can be
associated with multidirectional instability (see
below). The pain is normally felt around the
shoulder and the outside of the arm and is normally
worse when lifting your arm above 90 degrees.
Biceps Tendonitis
Is exactly what it says: it is an inflammation of the
biceps tendon. Again this is normally associated
with an injury and the pain is normally felt at the
front of the shoulder. It can be worse on bending
the elbow and extending the shoulder when reaching
back.
Instability
This is normally due to genetics, where the ligaments
in the shoulder are looser than normal. This means
you are much more reliant on the muscles to provide
stability and if over used it can break down and
sometimes cause other conditions such as impingent
syndrome. Treatment would be focussed on the
impingent syndrome whist giving advice and exercise
to strengthen the shoulder muscles. If this fails
there is a surgical option.
Other
There are many other conditions that affect the
shoulder, such as osteo-arthritis. Although this is
very rare in the shoulder itself it is quite common
in the joint next to it, at the end on the collar
bone, called the acromio-clavicular joint. |
