Accidents and Injuries

Stiffness and pain developing in the shoulder could be adhesive capsulitis, (frozen shoulder), a condition in the shoulder's ball-and-socket joint/glenohumeral joint. It usually develops over time and limits the functional use of the arm. The pain and tightness restrict arm movement, and the duration of symptoms can persist for 12-18 months. The cause is often unknown, but it is more common in individuals over 40, individuals with diabetes, thyroid disease, and cardiac conditions have an increased risk of developing the condition, and women tend to develop the condition more than men. Chiropractic treatment can be effective at relieving pain and expediting recovery.

Stiffness and Pain

The shoulder joint allows more movement than any other joint in the body. A frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue. The capsule contraction and the formation of adhesions cause the shoulder to become stiff, restrict movement, and cause pain and discomfort symptoms.

Stages

The progression is marked by three stages:

Freezing

• Stiffness and pain begin to restrict motion.

Frozen

• Movement and motion are severely restricted.

Thawing

• The shoulder starts to loosen up.
• It can take years to fully resolve symptoms.
• In mild cases, a frozen shoulder can go away on its own but that does not mean that it is truly healed and correctly aligned.
• Even in mild cases seeking treatment is recommended, rather than just waiting for it to go away.

Symptoms

• Limited range of motion.
• Stiffness and tightness.
• Dull or aching pain throughout the shoulder.
• Pain can radiate into the upper arm.
• Pain can be triggered by the smallest movements.
• The symptoms are not always due to weakness or injury, but actual joint stiffness.

Causes

Most frozen shoulders occur with no injury or discernible cause but the condition is often linked to a systemic condition or one that affects the entire body.

Age and Gender

• Frozen shoulder most commonly affects individuals between the ages of 40 to 60, and is more common in women than in men.

Endocrine Disorders

• Individuals with diabetes have an increased risk of developing a frozen shoulder.
• Other endocrine abnormalities like thyroid problems can also lead to the development of this condition.

Shoulder Trauma and/or Surgery

• Individuals who sustain a shoulder injury, or undergo surgery on the shoulder can develop a stiff and painful joint.
• When injury or surgery is followed by prolonged immobilization/resting the arm, the risk of developing a frozen shoulder increases.

Other Systemic Conditions

Several systemic conditions such as heart disease have also been associated with an increased risk of developing the condition and can include:

• High cholesterol
• Adrenal disease
• Heart and lung disease
• Parkinson's disease

Stiffness and pain can also be associated with damage to the joint from injuries or other shoulder problems that include:

• Muscle or connective tissue injury
• Rotator cuff tendinopathy
• Calcific tendinitis
• Dislocation
• Fracture
• Osteoarthritis
• A frozen shoulder associated with any of these causes is considered secondary.

Treatment

A diagnosis is made by observing the range of motion in the shoulder, considering the two types:

Active Range

• This is how far an individual can move a body part on their own.

Passive Range

• This is how far another person like a therapist or doctor can move the body part.

Therapies

• Chiropractic, massage, and physical therapy involve stretches, realignment, and exercises to relieve pain symptoms and restore mobility and function.
• Usually, strength is not affected by a frozen shoulder but a chiropractor may want to strengthen the surrounding muscles to better support the shoulder and prevent worsening the injury or causing a new injury.
• Anti-inflammatory medications and corticosteroid injections may help manage pain symptoms.
• Getting a diagnosis and treatment during the freezing stage can keep the condition from progressing and expedite recovery time.

Enhancing Health: Evaluation and Treatment

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Brun, Shane. “Idiopathic frozen shoulder.” Australian Journal of general practice vol. 48,11 (2019): 757-761. doi:10.31128/AJGP-07-19-4992

Chan, Hui Bin Yvonne, et al. “Physical therapy in the management of frozen shoulder.” Singapore medical journal vol. 58,12 (2017): 685-689. doi:10.11622/smedj.2017107

Cho, Chul-Hyun, et al. “Treatment Strategy for Frozen Shoulder.” Clinics in orthopedic surgery vol. 11,3 (2019): 249-257. doi:10.4055/cios.2019.11.3.249

Duzgun, Irem, et al. “Which method for frozen shoulder mobilization: manual posterior capsule stretching or scapular mobilization?.” Journal of Musculoskeletal & neuronal interactions vol. 19,3 (2019): 311-316.

Jain, Tarang K, and Neena K Sharma. “The effectiveness of physiotherapeutic interventions in the treatment of frozen shoulder/adhesive capsulitis: a systematic review.” Journal of back and musculoskeletal rehabilitation vol. 27,3 (2014): 247-73. doi:10.3233/BMR-130443

Kim, Min-Su, et al. “Diagnosis and treatment of calcific tendinitis of the shoulder.” Clinics in shoulder and elbow vol. 23,4 210-216. 27 Nov. 2020, doi:10.5397/cise.2020.00318

Millar, Neal L et al. “Frozen shoulder.” Nature reviews. Disease primers vol. 8,1 59. 8 Sep. 2022, doi:10.1038/s41572-022-00386-2

The thoracic spine, also known as the upper or middle back, is designed for stability to anchor the rib cage and protect the organs in the chest. It is highly resistant to injury and pain. However, when thoracic back pain does present, it is usually from long-term posture problems or an injury. Thoracic back pain is less common than lower back and neck pain, but it does affect up to 20% of the population, particularly women. Treatment options include chiropractic for quick and long-term pain relief.

Thoracic Back Pain and Soreness

The thoracic area is vital for various functions related to:

• Breathing mechanics
• Optimal arm function
• Organ protection
• Trunk support
• Nervous tissue health

Common reasons for experiencing thoracic back pain include:

• A direct hit or high-impact injury from a fall.
• Sports injury.
• Automobile accident.
• Unhealthy postures that put the spine in chronic misalignment, causing strain.
• Repetitive overuse injury from bending, reaching, lifting, twisting.
• Poor core or shoulder mechanics, causing muscle imbalance.
• Muscular irritation, the large upper back muscles are prone to developing strains or tightness that can be painful and difficult to alleviate.
• De-conditioning or lack of strength.
• Joint dysfunction can come from a sudden injury or natural degeneration from aging. Examples include facet joint cartilage tear or joint capsule tear.

Upper back pain usually feels like a sharp, burning pain localized to one spot or a general achiness that can flare up and spread out to the shoulder, neck, and arms.

Types of Upper Back Pain

These include:

• Myofascial pain
• Spine degeneration
• Joint dysfunction
• Nerve dysfunction
• General spinal misalignments

Depending on what specific tissues are affected, pain can occur with breathing or arm use. It is recommended to have a healthcare professional perform an examination and get an accurate diagnosis. A chiropractor understands the delicate balance and functions that the thoracic spine provides and can develop a proper treatment plan.

Chiropractic

Treatment options will depend on the symptoms, underlying dysfunctions, and individual preferences. ​Recommendations for treatment often include:

• Spine adjustments to improve alignment and nerve integrity.
• Posture training to maintain spinal alignment.
• Therapeutic massage.
• Exercise training to restore muscular balance.
• Non-invasive pain-relieving techniques.
• Health coaching.

Body Composition

Plant-Based Diets for Weight Loss

Individuals who follow vegan, vegetarian, and semivegetarian diets have reported and shown they are less likely to be overweight or obese. This can indicate that reducing intake of meat and animal products is beneficial for weight loss. Studies have found that individuals who follow a vegan diet may lose more weight than individuals on a more conventional weight loss diet, even with similar calories consumed, and often have significant improvements in blood sugar and inflammation markers.

Plant-Based Protein and Muscle Gain

Some plant-based proteins are just as effective as animal protein at promoting muscle gain. A study found that supplementing rice protein following resistance training had similar benefits to whey protein supplementation. Both groups had:

• Decreased fat mass
• Increased lean body mass
• Skeletal muscle hypertrophy
• Improved power and strength

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic spine pain in the general population: prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord. 2009;10:77.

Cichoń, Dorota et al. “Efficacy of Physiotherapy in Reducing Back Pain and Improve Joint Mobility in Older Women.” Ortopedia, traumatologia, rehabilitacja vol. 21,1 (2019): 45-55. doi:10.5604/01.3001.0013.1115

Fouquet N, Bodin J, Descatha A, et al. Prevalence of thoracic spine pain in a surveillance network. Occup Med (Lond). 2015;65(2):122-5.

Jäger, Ralf et al. “Comparison of rice and whey protein isolate digestion rate and amino acid absorption.” Journal of the International Society of Sports Nutrition vol. 10,Suppl 1 P12. 6 Dec. 2013, doi:10.1186/1550-2783-10-S1-P12

Joy, Jordan M et al. “The effects of 8 weeks of whey or rice protein supplementation on body composition and exercise performance.” Nutrition journal vol. 12 86. 20 Jun. 2013, doi:10.1186/1475-2891-12-86

Medawar, Evelyn et al. “The effects of plant-based diets on the body and the brain: a systematic review.” Translational psychiatry vol. 9,1 226. 12 Sep. 2019, doi:10.1038/s41398-019-0552-0

Newby, PK et al. “Risk of overweight and obesity among semivegetarian, lactovegetarian, and vegan women.” The American journal of clinical nutrition vol. 81,6 (2005): 1267-74. doi:10.1093/ajcn/81.6.1267

Pope, Malcolm H et al. “Spine ergonomics.” Annual review of biomedical engineering vol. 4 (2002): 49-68. doi:10.1146/annurev.bioeng.4.092101.122107