In over twenty years of practice, I have seen thousands of patients. While low back and neck pain are certainly the most common reasons patients seek chiropractic care, shoulder pain would absolutely rank in the top ten.
One of the most interesting aspects of treating a shoulder problem is that what a patient calls shoulder pain is, in actuality, thoracic pain.
The thoracic spine is a series of twelve vertebrae that travel from the neck to about the bottom of the rib cage. The upper thoracic spine is about the level of the scapula and this is a prime area for pain and muscle tightness.
The first thing I do when a patient presents complaining of shoulder pain is ask them to show me where the pain is most strongly felt.
Often, the patient will reach back over the trapezius muscle (the big muscle between the neck and the shoulder and reach for their upper thoracic area.
Once a patient does that, I zero in on the thoracic spine and continue the evaluation reasonably confident that that main problem is not in the actual shoulder itself.
One must always bear in mind, of course, that there may be more than one problem going on at the same time.
If, when asked to point at the area of pain, the patient does indicate at their actual shoulder, then I can be fairly confident that the problem is in the shoulder itself.
The next step is a detailed consultation. In many cases the cause of the shoulder pain is easy to determine. It may be a football injury or an auto accident for instance.
But sometimes, there is no known cause. The patient just wakes up one day with a sore shoulder.
The next step is range of motion and muscle testing to determine what exactly is injured and what is extent of the injury. If necessary, the patient may be referred out for an MRI to further evaluate the shoulder joint.
Once a diagnosis is made, treatment consists of three phases.
1. Pain control and swelling
2. Restore normal range of motion
3. Strengthen the muscles to prevent re injury.
It is impossible to go into any depth regarding rehabilitation, as all patients are different and treatment is prescribed on an individual basis.
The important thing to remember is this: What you think is shoulder pain, might not really be shoulder pain.
If you have any questions, feel free to contact me through my web site. http://www.waalechiropractic.com
Article Source: http://EzineArticles.com/?expert=David_Waale
No comments:
Post a Comment