Shoulder Pain: Chiropractic Diagnosis and Treatment Explained

Written by Dr Elena Bacash, Chiropractor & Acupuncturist

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Shoulder pain is one of the most common musculoskeletal issues, affecting people of all ages—from office workers to athletes. The shoulder is the most mobile joint in the body, it’s also one of the most prone to injury, instability, and dysfunction. Chiropractic care offers a holistic, non-invasive way to assess and manage shoulder pain by looking not just at the joint itself, but how it works with the rest of the body.

Understanding the Shoulder Complex

The shoulder isn’t just a single joint—it’s a system of several joints working together:

• Glenohumeral joint (ball-and-socket)

• Acromioclavicular (AC) joint

• Sternoclavicular joint

• Scapulothoracic articulation

For the shoulder to move properly, all of these structures need to work in sync, along with the surrounding muscles, ligaments, and nerves. If something isn’t functioning well in one area, it can lead to pain, weakness, or limited movement.

Common Shoulder Conditions

Chiropractors commonly see a range of shoulder problems, including:

Rotator Cuff Injuries
Strains or tears in the rotator cuff can cause:

• Pain when lifting or reaching

• Weakness

• Discomfort at night

Adhesive Capsulitis (Frozen Shoulder)
This condition typically involves:

• Gradual stiffness

• Painful restriction of movement

• Loss of function over time

Shoulder Impingement Syndrome
Happens when soft tissues get compressed during movement:

• Pain when raising the arm

• Reduced range of motion

• Inflammation of tendons or bursa

Acromioclavicular (AC) Joint Dysfunction
Often linked to trauma or overuse:

• Pain at the top of the shoulder

• Discomfort with cross-body movements

Referred Pain from the Neck
Not all shoulder pain starts in the shoulder:

• Issues in the cervical spine can refer pain into the shoulder

• May come with stiffness or nerve-related symptoms

Chiropractic Diagnosis

Chiropractors use a thorough assessment to figure out what’s really causing the pain.

Case History
This usually covers:

• When the pain started

• How the injury happened (if applicable)

• What makes it better or worse

• Lifestyle and work-related factors

Physical Examination
This may include:

• Range of motion testing (both active and passive)

• Muscle testing

• Orthopedic tests (like impingement or rotator cuff tests)

• Palpation to check for tenderness, tight muscles, or joint restriction

Functional Assessment
Rather than looking at the shoulder in isolation, chiropractors assess how it works with:

• The spine (especially the neck and upper back)

• The scapula (shoulder blade movement)

• Overall posture and movement patterns

Imaging (if needed)
If required, imaging may be used:

• X-rays to rule out fractures or joint changes

• Ultrasound for soft tissue injuries

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Chiropractic Treatment Approaches

Treatment focuses on restoring movement, reducing pain, and improving overall function.

Adjusting the joint and related spinal region

• Joint Mobilisation and Manipulation

• Gentle adjustments to the shoulder, spine, or ribs

• Helps restore normal joint movement and reduce stiffness

Soft Tissue Therapy
May include:

• Myofascial release

• Trigger point therapy

• Instrument-assisted techniques

These approaches help reduce muscle tension and improve circulation.

Rehabilitation Exercises
A key part of recovery:

• Strengthening the rotator cuff and shoulder stabilisers

• Improving mobility and control

• Addressing muscle imbalances

Postural Correction
Poor posture—especially forward head position and rounded shoulders—can contribute significantly to shoulder pain. Treatment may involve:

• Ergonomic advice

• Adjustments to your workstation

• Postural retraining

Adjunct Therapies
Depending on the practitioner, this might include:

• Acupuncture

• Taping

• Ultrasound therapy

• laser

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