Severe shoulder pain that limits mobility of the shoulder is often characteristic of acute bursitis/tendonitis of the shoulder. The condition may or may not be associated with an injury. It was once accepted that calcification was responsible for rupturing the bursa in this type of shoulder pain but the idea has not been shown to be true. Calcification of the shoulder tendons is most often seen in persons between 30-60 years old. Many persons may show marked calcification of the shoulder yet have no pain or limited range of motion. The pain and bursitis of this type of shoulder pain is most likely due to inflammatory processes.
Chiropractic management may involve limiting the movements of the shoulder via a sling or support. Ultrasound treatment has been shown to have benefit as well. In the initial phases of treatment often patients are in such severe pain that pain medications may be indicated.
Frozen shoulder refers to a condition which causes pain and limited mobility of the shoulder. Usually this condition effects persons over 40 years old. In the acute phase the shoulder is often moderately to very painful and all motions are limited. Usually there is not an injury or episode associated with the start of pain and reduced mobility. The pain of acute frozen shoulder may make it difficult to sleep.
After several months of pain a person may notice lifting the arm or turning it out is difficult. Most often motion gradually returns but still may remain limited.
The cause of frozen shoulder is unknown. The most accepted theory is that fibrous adhesions develop in the joint capsule of the shoulder. Some persons may be predisposed to frozen shoulder such as diabetics or those with heart conditions. It appears that frozen shoulder is not associated with immobilization.
The initial pain phase of frozen shoulder is difficult to treat. Chiropractic care including myofascial release is most effective once the pain has largely subsided in the 1-3 month range. The most commonly recommended exercises include arm pendulum and wall walking with the arm. Mild Chiropractic mobilization of the arm is often effective in increasing range of motion. Significant improvement should occur within 1-3 months.
Dizziness is one of the most common complaints in the Chiropractic setting. Dizziness is often one of the most common complaints after a whiplash injury to the neck. Dizziness may occur in as much as 50% of the elderly. Dizziness may be perceived in a number of ways. In some instances the room may spins. Other types of dizziness may be felt as an imbalance of motion, lack of coordination, lightheadedness or a sensation of being near fainting. Spinning rooms are most often the result of inner ear dysfunction. Lightheadedness is usually attributed to circulatory conditions.
Cervicogenic vertigo refers to dizziness caused by the neck. Usually a history of neck trauma, muscle spasm and restricted motion of the neck is associated with cervicogenic vertigo. The Chiropractic approach is to address the joint dysfunction with adjustments to the spine and myofascial release techniques to address tight muscles and trigger points. Trigger points in the muscles of the neck may refer pain into the face or head and may cause dizziness if compressed or irritated.
Benign paroxysmal positional vertigo refers to vertigo that is associated with dysfunction of the inner ear. This condition causes vertigo at certain head positions and the vertigo lasts for seconds to minutes. Such things as bending over, head turning or rolling over in bed are known to trigger the condition. Trauma is one possible cause. Older persons are more at risk due to lower functioning of the canals of the inner ear. The treatment is most often exercises that place the head in the irritating position until the vertigo stops or repositioning exercises. Medication and surgery are not often used. Benign paroxysmal positional vertigo is the most common cause of vertigo
Meniere’s disease is sudden and severe vertigo that is associated with hearing loss and ringing of the ears. The vertigo can last for several hours or a day. Head trauma or infections are sometimes a cause of Meniere’s disease.
Persons who are experiencing numbness or tingling usually have involvement of the nerves. The list of possible causes of numbness is extensive. One of the most common causes of numbness is diabetes related numbness. In the Chiropractic setting numbness is often reported in which the cause is not able to be determined. Referred pain or sensory changes from other parts of the body are a possibility in cases such as these.
Changes in sensory perception at the skin may be either numbness (known as paresthesia) or what is known as dysesthesias (irritating sensations provoked by light touch).
Diabetic neuropathy is often indicated by a family history or diabetes. Diabetic neuropathy is associated with decreased reflexes and reduced sensation in the hands and feet. Some neuropathies may be inherited. Usually a family history of neuropathy is present. In inherited neuropathy hammer toes, decreased reflexes and decreased sensation in the hands and feet are present.
In the Chiropractic setting numbness in the side of the thigh is a common complaint. This condition is known as Meralgia paresthetica. The condition may be caused by pregnancy, prolonged sitting, diabetes or wearing a holster or belt.
Bursitis is a common cause of pain in the hip. Pain on the side of the hip may be the result of bursitis (trochanteric bursitis). This type of pain is usually localized to the side of the hip and may produce a minor limp. Bursitis of the hip is often seen in the age group of 40-60. Bursitis in the side of the hip may also radiate into the lower back, thigh and knee. Sleeping on the painful side is often not possible. Bursitis of the hip is often due to long term overuse and excessive motion may irritate active cases of bursitis. Pain in the lower back is also a contributor to hip bursitis. Most any condition that causes pain in the lower back or hip may be a cause of bursitis in the hip.
Stretching of the muscles of the side of the hip (gluteus medius) are often helpful. Persons suffering from hip bursitis should avoid activities such as walking on side sloping surfaces. Rest is helpful in the acute phase. Some running strides may also be irritating such as running with a stride in which the foot crosses the midline of the body.
Dr. Tom Etter is a Chiropractor with over ten years of practice experience. Etter Chiropractic serves Olathe, Kansas, Lenexa, Kansas, Overland Park, Kansas and the surrounding areas.