Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. It occurs when the connective tissue surrounding the shoulder joint becomes thick, tight, and inflamed, restricting motion and causing discomfort. Frozen shoulder affects around 2-5% of the general population and is most common in people between the ages of 40-60 years old. Women are affected more often than men.
Frozen shoulder develops gradually, often without a clear cause. It can occur after a shoulder injury or surgery but also arises on its own. There are three stages to frozen shoulder:
- Freezing – Gradual onset of pain and stiffness in the shoulder, lasting from 6 weeks to 9 months
- Frozen – Most painful and stiff stage, lasting around 4-6 months
- Thawing – The shoulder slowly regains motion and function over the course of 12-42 months
Some patients wonder if seeing a chiropractor could help speed their recovery from frozen shoulder. Chiropractors use nonsurgical, drug-free approaches to treat musculoskeletal conditions. They are most well known for spinal manipulation but also utilize other techniques like massage, exercise instruction, and lifestyle advice.
Could chiropractic treatment effectively treat adhesive capsulitis and get the shoulder moving again? Let’s explore the evidence behind chiropractic care for frozen shoulder.
Does Chiropractic Work for Frozen Shoulder?
A handful of studies have looked at chiropractic treatment approaches for adhesive capsulitis. While more research is still needed, initial results are promising:
- A 2018 case study followed a 66-year old woman with stage 2 frozen shoulder undergoing chiropractic care. After 6 weeks of spinal manipulation, soft tissue work, stretching, and exercises, she regained full range of motion and reported no pain.
- A 2016 study had 50 frozen shoulder patients receive either spinal manipulation plus exercise or exercise alone. After 6 weeks, the manipulation group had significantly greater improvements in pain, range of motion, and function.
- A 2014 paper reviewed 4 clinical trials on manual therapy for frozen shoulder. They concluded there was moderate evidence that mobilization techniques improved movement and mixed evidence they reduced pain.
These early studies suggest chiropractic adjustments, massage, and stretching may help thaw a frozen shoulder. The benefits seem greatest when chiropractic is paired with at-home exercises.
However, more high-quality studies with larger sample sizes are still needed.Future research should also clarify which chiropractic methods are most effective. Mobilization techniques focus on gently moving the joint through its range of motion. Manipulation delivers a brief, controlled force to the stuck joint. Massage loosens up the shoulder muscles. It’s unclear which approach or combination works best.
Chiropractor Methods to Treat Frozen Shoulder
If you decide to see a chiropractor for adhesive capsulitis, what methods might they use? Techniques a chiropractor may employ to increase shoulder mobility include:
Spinal Manipulation
Chiropractors manually apply sudden, controlled forces to realign joints of the spine or extremities that are not moving correctly. This is called spinal manipulation or adjustment. It improves joint alignment and mobility by modifying the sensation and muscle tension around the joint. For a frozen shoulder, they will manipulate the shoulder joint itself and also the spinal joints of the neck and upper back.
Mobilization
Mobilization involves gently moving the joint through its range of motion. Low-grade oscillations or stretches are applied to the restricted joint to improve mobility, without the quick thrust of manipulation. Mobilization for frozen shoulder may involve range of motion exercises for the shoulder and backbone.
Soft Tissue Therapy
Massage and instrument-assisted soft tissue mobilization help relax the muscles around an affected joint. For frozen shoulder, a chiropractor might massage the shoulder muscles and use tools to break up adhesions. Gua sha scraping and active release technique (ART) massage are two specific instruments they may use.
Heat and Cold Therapy
Heat and ice can temporarily relieve pain and loosen tight tissues. Moist heat may be applied through hot packs. Cold therapy like ice massage numbs the area and reduces inflammation. Contrast bath therapy alternates hot and cold.
Movement Therapy and stretches
Chiropractors teach targeted stretches and exercises to improve mobility in a frozen joint. They instruct patients on movements to avoid that strain the shoulder. Traction techniques like the doorway stretch provide gentle distraction to the joint.
Postural and Lifestyle Advice
Tips to improve posture and ergonomics may help take pressure off an inflamed shoulder joint. Stress management and dietary changes reduce inflammation. Activity modification helps avoid overuse.
Benefits of Seeing a Chiropractor for Frozen Shoulder
Here are some potential benefits of trying chiropractic care for adhesive capsulitis:
- Drug-free pain relief – Chiropractic manipulation, massage, and exercises can reduce shoulder pain without medication or shots.
- Improve range of motion – Gentle joint mobilization techniques progressively increase mobility in a frozen shoulder.
- Reduce inflammation – Spinal adjustments may enhance shoulder function by affecting muscle tone, circulation, and nerve supply.
- Prevent freezing – Early chiropractic intervention may be able to stop early shoulder stiffness from advancing to a true frozen shoulder.
- Faster recovery – Some studies show chiropractic care can accelerate recovery from frozen shoulder vs. no treatment or exercise alone.
- Functional exercises – Chiropractors teach targeted stretches and exercises that translate into real-world abilities.
While chiropractors cannot cure frozen shoulder, they may help control symptoms and regain mobility faster, particularly in the early stages. Their hands-on techniques provide an alternative to pain medication or surgery. Chiropractic seems most effective when paired with at-home exercises.
Risks and Considerations
Chiropractic manipulation has some risks and limitations to consider:
- There is a small chance of injury from forceful joint manipulation.
- Results vary widely between patients due to technique differences.
- Benefits are often temporary without continuing care.
- It does not change the underlying disease process.
- Frozen shoulder may still run its natural course over 12-18 months.
- Not recommended if inflammation is still high or bones are fragile.
Make sure to communicate all your symptoms and medical history to avoid complications. While uncommon, disc herniations, fractures, dislocations, and sprains have been reported with forceful adjustments, especially of the neck.
Chiropractic care should be viewed as one piece of a comprehensive plan including medications, stretching, and exercise. It requires an ongoing commitment for continued results.
Who is a Good Candidate for Chiropractic Care?
Chiropractic treatment may be worth considering for adhesive capsulitis if:
- You want conservative therapy before considering surgery.
- Other treatments like physical therapy, massage, and medication have not helped.
- You are in the early frozen or thawing stages.
- You are healthy enough for forceful joint manipulation.
- You do not have severe osteoporosis or joint instability.
- You are willing to do daily at-home exercises.
Chiropractic care is less likely to succeed if:
- Your shoulder joint is completely immobilized in the frozen stage.
- You have highly advanced frozen shoulder or osteoarthritis.
- You cannot tolerate manual manipulation due to pain or fragility.
- You do not stick to the home exercise program.
Have an open discussion with your chiropractor to determine if their techniques are appropriate for your situation.
How to Find a Good Chiropractor
Take these steps to locate a skilled chiropractor in your area:
- Ask your doctor for a recommendation or referral.
- Search online directories through the American Chiropractic Association or International Chiropractors Association.
- Look for chiropractors with accredited Diplomate or Fellow status.
- Verify the chiropractor’s license through your state licensing board.
- Select a clinic close to your home or office.
- Schedule a consultation to discuss your condition and ask questions.
Things to ask potential chiropractors:
- How much experience do you have treating frozen shoulder?
- What techniques and methods do you use?
- How long is a typical treatment plan?
- How many visits per week will be needed?
- Do you collaborate with physical therapists or orthopedists?
Choose an experienced chiropractor you feel comfortable with. They should clearly explain their approach and expected outcomes.
Conclusion
Early research indicates chiropractic care may be beneficial for frozen shoulder pain and mobility. Spinal manipulation, massage techniques, and targeted exercises help restore range of motion and function. However, benefits are temporary without ongoing care. It seems most effective along with conventional treatments in motivated patients. Discuss with your chiropractor to see if a trial of conservative care is appropriate before considering surgery. While not a cure, chiropractic offers a hands-on, drug-free option to potentially accelerate recovery.