25 out of 1,000 visits to the family doctor are related to shoulder pain. This is currently the cause of 13% of sick leaves, and it costs the American health system 7 billion dollars. What is the best treatment for shoulder pain?
As a patient you have several choices of types of doctors and several types of treatment available to you. Your MD may prescribe pain killers and muscle relaxer, while a trip to the PT may result in a sessions ultrasound, muscle stimulation, and some light stretching. Some may have mentioned a chiropractor that treats shoulder using manipulation, but does that really work? Has anyone done research on these different approaches to find out what really the best???
Well I have scanned the internet for you and come up with these results, and spoiler alert, it may not be what you thought!
Spinal manipulation versus medical care:
A 2004 study by the University Hospital of Groningen, Netherlands involved 150 shoulder patients, assigned to 2 groups. The authors compared the effectiveness of spinal manipulation and medical care to relieved shoulder pain. One group received the standard medication, injections, physical therapy, etc. and the other received manipulation. Surprisingly, the results demonstrated that six treatments of manipulation help twice as many patients feel “recovered” compared to up to 12 weeks of standard medical treatment. (Bergman GJ, et. al, 2004).
Manipulation is more effective than physiotherapy
A 1997 study conducted by Department of General Practice, Netherlands published that chiropractic manipulation offers greater relief than physiotherapy. This study was involved by 172 patients who divided to two groups. The result showed that 70% of patients felt cured after 5 weeks of manipulation. (Winters JC, et. al., 1997) (Page 310).
In 1999 a follow up study from University of Groningen, involved the same 172 patients 2-3 years later and found that 67% of chiropractic patients were still symptom-free, compared to 41% of physiotherapy treated patients. (Winters JC, et. al., 1999) .
So chiropractic manipulation has proven to be highly successful treatment for shoulder injuries, but how many treatments does it take?
The power of a single adjustment
One study found that even a single chiropractic adjustment can substantially decrease the intensity of shoulder pain. In 2009 the Department of Rehabilitation Sciences, University of Toronto, recruited 21 patients with unilateral shoulder pain. They reported that shoulder pain sufferers had a nearly 40% reduction in pain, after only one chiropractic adjustment. (McClatchie L, et. al., 2009).
Shoulder impingement syndrome, SIS?
What is better for SIS exercise, or chiropractic and exercise? In 2000 Kaiser Permanente Medical USA researched chiropractic manipulation with exercise or just exercise without manipulation. Of the 52 subjects were involved in this study, those receiving manual therapy along with exercise demonstrated a 70% decrease in pain compared to a 35% decrease in the exercise only group. (Bang MD, et. al., 2000).
Would massage be helpful Doc?
A 2010 Canadian study of 50 patients with chronic shoulder injuries in Trois-Rivières, Québec. Those patients receiving ischemic compression (a style of massage) showed improvements up to 80% within 5 weeks. (Hains, et. al., 2010)