Whether it stems from a pinched nerve of a strain to the rotator cuff, shoulder pain, if left untreated, can cause debilitating discomfort. For this reason, many people who experience shoulder pain will seek chiropractic care that often consists of a regime of regular adjustments and exercise.

"A lot of people, especially men, will procrastinate if they have shoulder pain. Many people will assume it will just go away. But it's important to have shoulder discomfort evaluated," says Dr. Eric Plummer, a chiropractor with a Castle Rock, CO.-based private practice called Alternative Health & Wellness. "The shoulder is a very mobile joint that affords a lot of range of motion. But as a result of this, the shoulder is a joint that doesn't have a lot of inherent stability. If you start to lose stability in the shoulder that's when you can advance from an easy-to-treat condition to something that might require more invasive therapy."

To properly pinpoint where shoulder pain is originating from, a chiropractor will often check a patient's shoulder blade mechanics. "Statistics show that 95% of shoulder pain can be traced back to faulty shoulder blade mechanics," claims Dr. Brett Winchester, who sees many patients with shoulder pain in his private practice, Winchester-Hilgefort Spine & Joint Center in Moscow Mills, MO. "A lot of people say faulty shoulder blade mechanics is due to the forward drawn, rounded shoulder position so many people have when they sit down." Therefore, poor shoulder blade mechanics often stem from bad posture, which is another common cause of shoulder pain.

Sitting Tall
"Poor posture can occur by the way you sleeps, such as if you sleep with two pillows, it can force your head forward," says Dr. Lawrence S. Beck, a chiropractor who treats many patients for shoulder pain at his Coram, NY private practice, Beck Chiropractics. "Also, if you work at a computer terminal where the terminal is down too low and you have to force your head forward to read, this can cause poor posture as well. Your chin should be up, so the curve in the neck is maintained,"

Another common cause of shoulder pain is a pinched nerve in the neck, which can occur as a result of improper posture or trauma, says Beck. "Chiropractors can correct the pinched nerve by correcting the misalignment of the vertebrae, which takes the pressure off the nerve," he says.

Off The Cuff
Shoulder pain also can be caused by strain to the rotator cuff, which often occurs as a result of repetitive activity or while playing sports. "One thing about the rotator cuff is to make sure the tissue is stretched properly and warmed-up in anyone who uses their arms and shoulders regularly, such as baseball pitchers," says Beck. "The best exercise to warm up the rotator cuff is to take your arm over your head with you elbow bent at a 90 degree angle, and have your forearm straight over your head with your elbow bent at a 90 degree angle, and have your forearm straight over your head stretching the rotator cuff area."

To treat rotator cuff injuries, it's important to first alleviate other elements that may be contributing to shoulder pain. "The reason so many treatments fail in the shoulders is because people want to go right to that exact area where it hurts. We usually address the rotator cuff after we've addressed posture and shoulder blade mechanics," says Winchester, noting that on someone with an injured rotator cuff, he'll often use the "active release" technique, which is a process that helps break up adhesion in the muscle.

When seeking chiropractic treatment for a strained rotator cuff, it's also important for patients to educate themselves about how to avoid future injury. "Maybe the patient is a weight-lifter who isn't following proper form, so the chiropractor wants to make sure he doesn't continue to put his shoulder in a vulnerable position," says Plummer.

Healthy Manipulation
When patients come to his office complaining of should pain, Beck will often have them undergo a complete chiropractic, neurological and orthopedic examination to see where the pain stems from. "We also take X-rays of the shoulder, neck and upper back. We evaluate the findings, and determine the best course of action," says Beck. Often the remedy will include chiropractic manipulation and adjustments, along with ultrasound and electrical stimulation after the first 72 hours of icing. "If it's an acute situation, I'll often have the patient put the arm in a sling, so when they are not using it, it will give it a chance to heal a little on its own. This helps patients stop using their shoulders, and therefore, prevents them from reinjury," he said. "Once some of the inflammation and swelling starts to subside, depending on the situation, I'll start the patient on exercises that are going to very gently go through a range of motion with the shoulder, including raising the shoulder up to the point of pain, and then releasing it."

Exercising Your Options
Other exercises chiropractors often teach their patients to help relieve shoulder pain include wall angels. "The wall angel is an exercise where your back is up against a wall, and you externally rotate your arms," instructs Plummer. Meanwhile, an exercise that helps correct faulty shoulder blade mechanics is the push-up plus. "You do the push-up plus on all fours with your elbows straight," says Winchester. "That's the main way to facilitate the serratus anterior muscle." As a patient's condition starts to heal, chiropractors can prescribe more aggressive exercises that utilize the Theraband, which is a resistance band, as well as light weights to increase range of motion, says Plummer.