The frozen shoulder that wasn’t and how to get the right care for you.

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Patients are often diagnosed with all sorts of shoulder conditions based on their symptoms rather than the functional reason for the pain.   It seems that they are often inevitably sent to an orthopedic who inevitably after taking some x-rays and injecting the shoulder refers them to someone else who follows a prescription for therapy to the area of complaint. This one size fits all approach often fails to resolve the problem since it works on the symptom while improperly diagnosing why your shoulder hurts. Typical one size fits all diagnoses I have seen include bursitis, tendonitis, frozen shoulder, and impingement syndromes which are the most common. Recently, a patient visited our office with a shoulder problem that seemed to have started after a covid shot.   The area felt sore initially and then worsened and eventually, she had difficulty and pain lifting the shoulder laterally or even sleeping on the shoulder without marked pain. The most commonly reported side effect of the flu shot is not the vaccine but from secondary effects of improperly administering the shot resulting in severe shoulder pain often lasting months.    While common side effects of the flu shot include muscle aches throughout the body that can last for months. She visited an orthopedic who initially took an x-ray and then injected it which was very painful.    She was then sent for physical therapy but asked me about it at a family function.   Having treated thousands of shoulders, I suggested she see me professionally. [caption id="attachment_4717" align="alignleft" width="272"] shoulder Joint Capsule[/caption]

What is a frozen shoulder?

A frozen shoulder occurs when the capsule, the material surrounding the shoulder joint shortens and tightens, restricting movement in the joint.   The scapula and humerus which should move independently begin to move together resulting in pain and tightness first in the shoulder and shoulder blade and then within the shoulder itself.  The surrounding muscles and tendons become very sore and pain and it becomes painful and difficult to move the shoulder. Often, a frozen shoulder is found in conjunction with other functional problems in the lower body and capsular problems in the hips as well. Our bodies move as a unit vs the idea that it's just a bunch of disjointed parts that go bad.  If you go to the park and watch people walk, you will see that there are no shoulders in the wild but there are people who have shoulders.   Notice how the shoulder is part of how we move. Then imagine we restrict movement in the lower body; how does that affect how our upper body moves?   Years later these maladaptive patterns result in problems such as impingement, shoulder capsule problems, or frozen shoulder, and even scapular winging which is often a sign of a shoulder capsule problem rather than a neurological one which is what most of us were taught in school years ago

What are other common painful conditions of the shoulder?

Tears and impingements are often postural problems that develop from lower body compensations such as flat feet or feet that flare out.   This type of foot posture will result in shoulders that roll forward resulting in impingement. Unfortunately, most sources ignore how the body causes the tear or impingement and instead talk about the classical definition of the condition.   Most sources will say basically the same thing; Things just happen and then see a doctor. This is dinosaur-level thinking about how your body works. Worse, the health systems love one size fits all approaches they can scale up.  This factory approach to healthcare often fails in the musculoskeletal system because we are all different, come from different parents, and are different shapes, sizes, and weights. Musculoskeletal care must be personalized to the person having the problem.

What went wrong in this patient's case?

During our casual conversation after she asked me about the shoulder, I immediately knew to ask what else she suffers from. Unsurprisingly, she had a laundry list of problems in the back, neck, hips, and knees which affected her sleep and in those instances, she went the same route and found the therapy to be ineffective and has been living with pain for years after many medical approaches have failed to help. Pain is often more than an inconvenience needing to be treated.  Usually, there is a mechanical basis for it but there can also be a nutritional basis as well relieved by better nutrition and adequate vitamin D. Inflammation in the body due to obesity, insulin resistance, lack of sleep and stress can also cause chronic pain.  For most people, there are usually a few reasons for chronic pain.

Where conventional medical thinking gets musculoskeletal problems wrong.

Medically, they look at the symptoms and then exhaustively treat and examine the area, while ignoring the rest of the body.  They also have segmented care so one doctor refers to another who makes a diagnosis and refers to another and so on.   The only thing that has continuity is the diagnosis, not the treatment, and all too often, too many providers pass the patient around to the next provider hoping they solve the problem. This idea fails spectacularly when treating musculoskeletal problems.   A holistic approach to musculoskeletal problems made individualized to you is often the most effective way to solve problems.  Chiropractors are trained holistically and are primary care for the musculoskeletal system.  Seeing a chiropractor first can make a huge difference in cost, testing, and your overall outcome. Got shoulder pain?   Think chiropractic first.  Book online here.