As her treatment progressed and her shoulder bursitis improved, Linda a patient in my chiropractic office, said: “I can’t believe my shoulder bursitis is coming from my neck.” She was surprised that chiropractic adjustments to correct misalignments of the spinal vertebrae in her neck was helping her chronic shoulder bursitis to improve. While Linda was the first patient to express herself in the way she did, she was by no means the first patient I’d had whose shoulder problem was improved by correcting spinal problems in the neck.
This article will discuss how chiropractic care can help shoulder problems, such as bursitis to improve. It will also introduce scientific research detailing a recent study of patients experiencing shoulder pain who benefited from chiropractic care.
A short, simple discussion of the anatomy of the shoulder will be helpful in understanding the condition of shoulder bursitis. To begin, a bursa is analogous to a water-filled balloon with a tough skin. We have bursas in many areas of our body. Correspondingly, they come in various shapes and sizes. Bursas keep two structures of the body from rubbing against each other. The bursa in the shoulder is called the subacromial bursa. It keeps a tendon from directly rubbing against a bone. Under normal conditions the bursa does its job day in and day out without causing any pain. However, when the bursa gets irritated it becomes inflamed. When something in the body is inflamed we use the suffix “-itis.” This is how the term “bursitis” is derived.
Chiropractors are always interested in what might be the cause of a particular health condition. It is very uncommon for a shoulder bursa to spontaneously become inflamed. So, it is important that we look at several other areas of the body as to the source and cause of the shoulder bursitis. Anything that would cause an abnormal pressure, compression or wear of the shoulder bursa might be the culprit.
We all know that there are many muscles involved with the movements of the shoulder joint. If those muscles are causing improper movement of the joint of the shoulder it can create an abnormal wear and strain of the subacromial bursa. However, once again, we must ask what might be causing the muscles to malfunction. This is where we can track the source of the problem back to the neck. The bones of the neck are called the cervical spinal vertebrae. These vertebrae protect the nerves of the spinal cord and allow spinal nerves to exit the spine to various areas of the body including the muscles of the shoulder.
If the spinal vertebrae are misaligned and moving improperly it can irritate or pinch spinal nerves. Those nerves innervate the muscles of the shoulder joint. If the nerves are sending improper signals to the muscles those muscles can cause the shoulder joint to move improperly and abnormally. This can create abnormal stress and wear upon the shoulder bursa, which leads to bursitis.
A scientific research study in the Journal of Back in Musculoskeletal Rehabilitation, September 2019 notes that when subacromial impingement syndrome occurs it can lead to pain, weakness and reduced range of motion in the shoulder. In a study involving 26 patients with acute subacromial impingement syndrome, researchers observed that those treated with manual therapy for four weeks experienced a significant improvement with respect to pain, function and range of motion.
Doctors of Chiropractic tend to look at the whole picture. Chiropractors examine not only the shoulder but the entire shoulder girdle and the cervical spine. Sometimes specialists such as an orthopedic practitioner might be too specific and only look at the shoulder joint. I’ve seen many cases where an orthopedic specialist gave a steroid injection into the shoulder bursa to reduce inflammation. A significant amount of the time this will give short-term pain relief but once the medication wears off the pain returns because the cause of the condition has not been corrected.
When misalignments or improper movement of the cervical spinal vertebrae are present, they must be corrected to eliminate the cause of the problem and commence healing. As a chiropractor I provide gentle, safe adjustments to the cervical spine to correct abnormalities. I will also utilize physical therapies such as electrical muscle stimulation, cold pack therapy and rehabilitative exercises to assist the bursa and the shoulder girdle to heal as quickly as possible.
By looking at the big picture and examining all significant aspects of a patient, chiropractors are able to help the majority of those suffering from shoulder bursitis.
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Dr. James Schofield 