Frozen Shoulder: Chiropractic or Physiotherapy?

Woman icing her sore shoulder

Frozen shoulder is a condition that unfortunately affects females more than males, usually appearing in the 40s to 50s age range, and can happen insidiously (suddenly without any reason) or after a trauma to the shoulder, like a fall. If you find that your shoulder has had a period of pain with increasing stiffness to the point that it is now difficult to lift you arm or scratch your back, you just might be dealing with a frozen shoulder.

We have covered what frozen shoulder, or adhesive capsulitis, is in our conditions page and this article will talk a little more about whether frozen shoulder is best treated by chiropractic or physiotherapy care! 

Does a chiropractor help with frozen shoulder?

Ultimately, yes. A chiropractor can help with treating a frozen shoulder, and perhaps not in the way that you might expect. When it comes to this condition, we know that one of the hallmark signs is the inability to raise and rotate your shoulder (i.e. putting it behind your back to hook your bra, or reaching out to grab something from an overhead shelf). However, we also forget that this movement does not just involve the shoulder joint. It also involves your neck and midback.

Our shoulder blade, or scapula, lies on top of your ribcage which is connected to your midback (or thoracic spine). As your shoulder blade moves on top of the ribcage, it requires adequate mobility of your midback to achieve the entire range of motion. 

Comparing the two skeletons, you will realise that the first guy (Skeleton A) is able to reach up higher than the second skeleton (Skeleton B) in front of him. What is the difference between the two of them? Skeleton A is actually able to extend and straighten his spine better than Skeleton B, who presumably has a stiff midback and is unable to assist the shoulder in lifting up. 

A chiropractor specialises in the mobility of the joints in our body, especially our spine. Oftentimes, we find that individuals suffering from frozen shoulders also have poor spinal mobility in their thoracic spine and that an adjustment helps to get things moving again. This also reduces the stresses placed on the shoulder during movements.

Does physiotherapy help with frozen shoulder?

This is also a resounding yes. Our shoulder has a complex interconnection of ligaments, joint capsules, tendons, and surrounding muscles – all which lend to its stability and mobility. When a frozen shoulder condition happens, an inflammatory process is triggered in the body which causes the passive structures (ligaments and capsule) to stiffen up.

When these passive structures thicken and cause fibrosis, the result is pain, stiffness, and a near total inability to achieve your shoulder’s full mobility. This can be frustrating, especially if you have work that cannot stop and a family to take care of. 

Physiotherapy treats frozen shoulders by focusing on increasing the mobility of the shoulder joint, reducing the tightness of the muscles around it (the active structures), and achieving strength and stability to gain back your independence in movement again. 

Here in Spinefit, a session treating frozen shoulder typically lasts at least 45 minutes and includes manual mobilisation of the shoulder joint, manual muscle release, and specific stabilisation exercises. These treatments have all been recommended in the standard treatment of care according to UKFROST guidelines for frozen shoulder. Shockwave treatment may also be prescribed if necessary. ESWT helps to increase the growth of new blood vessels in an injured area (angiogenesis) as well as triggers the process of healing again in chronic conditions, which frozen shoulder conditions can quickly turn into. 

Is there a therapy that is best for frozen shoulder conditions or shoulder pain – physiotherapy or chiropractic adjustments?

As with most injuries, the way your body best responds to injury and treatment will differ from individual to individual. Many people find that a combination of treatments help them to achieve their goals in a shorter period of time, and some find that they can achieve range of motion with just physiotherapy care or just chiropractic care.

Physical Doctor consulting with patient About Shoulder muscule pain problems Physical therapy diagnosing concept

Because of this wide range of outcomes, we always advise coming in for an initial consultation with one of our experienced practitioners so that an individualised treatment plan can be decided on. We do not believe in a one-size-treats-all treatment approach, and what works best for you may not work best for someone else. In fact, what one might think is a frozen shoulder might actually be an impingement or tendonitis issue. 

In short, there is no one treatment that is ‘best’ for shoulder pain. We must look at the entire body as a whole, consider a person’s occupation and demands of daily life, and compare it with the findings from our assessment to be able to give the right recommendation. If you are experiencing shoulder pain and stiffness and wondering if you should go to a chiropractor for frozen shoulder or do physical therapy, do book in for a consultation to gain clarity on your condition and direction for recovery!