While the anatomy of the shoulder allows for a wide range of motion and movement, it comes at the cost of a less stable joint, especially for those who routinely perform activities that require lifting the arms. This is likely why shoulder pain is one of the leading reasons patients seek chiropractic care, trailing behind low back and neck pain. The most common cause of shoulder pain is from tearing of the rotator cuff muscles (RCMs), particularly muscles that rotate the shoulder outward.
The “typical” rotator cuff tear patient is typically over 50 years of age with shoulder pain that has slowly worsened over time. A 2018 study found that as many as 96% of people over age 50 have RCM abnormalities, of which MANY are asymptomatic or non-painful. The study also reported that 24% of a random sample of 46 young people with an average age of 23 years old with no symptoms and no history of past injury, had degenerative changes in the RCMs. This finding supports the notion that rotator cuff injuries may occur early in adulthood and progress slowly until the symptoms drive a patient to seek care.
In a study involving 167 patients with rotator cuff tears, researchers observed no difference in outcomes one year after participants received either conservative care or surgery. This led the authors to recommend that non-surgical care, such as chiropractic care, should be considered as the PRIMARY method of treatment for rotator cuff tears of non-traumatic origin.
One study looked at impingement syndrome in a case series of four patients who received multimodal chiropractic care that included shoulder manipulation, shoulder girdle exercises, and ultrasound. In all four cases, the patients reported complete resolution of their shoulder pain and disability with five treatments. When researchers followed up with the patients four to eight weeks later, the participant’s symptoms had not returned.
A systematic review of data from 200 articles found evidence for the following non-surgical treatment options—which are commonly provided in chiropractic clinics—for shoulder pain: exercise training (specific favored over general), manual therapy, laser, extracorporeal shockwave, pulsed electromagnetic field (PEMF), transcutaneous electrical nerve stimulation (TENS), myofascial trigger point therapy, acupuncture, and microwave and light therapy.
For a patient with a rotator cuff tear, conservative chiropractic care is an excellent option for reducing pain and improving function in the affected shoulder!