Shoulders…”You Can Do That?”

Sarah came into the office yesterday as she normally does every couple of weeks.  She’s an avid golfer who prefers and relies on regular care to stay at the top of her game.  We are just one of her tools in her arsenal of providers so when she mentioned that she has been experiencing shoulder pain in the top and front of her shoulder I told her we might be able to help.  “You can do that? I thought you guys only cracked backs”.

Shoulder pain plagues between 16%-21% of the population and is the third leading cause for musculoskeletal pain.1 It often goes undiagnosed and untreated as patients fear the possibility of surgery, cortisone injections or other invasive procedures.  After working with the Minnesota Twins baseball team during my residency I developed a love for evaluating and treating this complex joint.  What patients didn’t realize was I suffered from my own right shoulder pain developed from an old weight lifting injury in high school.  

Empathizing with our patients and understanding the burden a shoulder injury puts on one’s life I began developing a conservative treatment program that is EFFECTIVE, CHEAP, and DURABLE.  The most important tool in our lineup is a piece of a new technology called acoustic wave therapy (AWT) or extracorporeal shockwave therapy (ESWT).  FDA approved and usually only available in high-end orthopedic clinics the device has exploded into the sports medicine world as a miracle machine. Couple this with a home exercise program developed by our physical therapists the outcomes are inevitable.  Since implementation, we have seen complete resolution of pain in 95% of our patients. 

After a couple of tests and 2 x-rays in house we determined that Sarah was likely suffering a labral tear.  Before ordering an expensive arthrogram to confirm the diagnosis and referring her to a surgeon we applied our shoulder protocol.  She reported immediate relief after yesterday after her first treatment of AWT and will likely have complete resolution after her 5th treatments for well under a thousand dollars.  

I love seeing the look on our patient’s faces after their first treatment.  I can’t always tell if its relief from the pain or surprise that a “chiropractor” does more than just crack backs.  So, I guess when it comes to shoulders. Yeah, we can do that.

Shoulder pain: diagnosis and management in primary care. BMJ. 2005 Nov 12; 331(7525): 1124–1128

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