Our body is a set of
psychophysical and functional relations and
correlations.
Taking into account this established fact, pains
in the shoulder can be caused by a trauma or a
physiologic disorder in the joint, but can also
be the consequence of irradiations from other
structures. In this case we can talk about
referred pain.
Here are some examples of
possible correlations with disorders in other
structures:
1. Neurologic integrity disorder at the
cervical ribs C5/C6. Deltoid, biceps, and
subscapolaris are concerned muscles, as they
are irradiation points of neurological
disorders.
2. The shoulder girdle is related to the pelvic
girdle and the internal organs; thus, to
solve the problem at the shoulder, it can be
necessary to treat pelvis and internal
organs too.
3. The shoulder disorder is directly connected
to the diaphragm disorder.
The cause of both
can be a compression to the rib C4, which
concerns the phrenic nerve, which innervates
the diaphragm.
4.
Periarthritis in the right shoulder
can be related to hepatic disorders.
Mobilization or drainage of the liver can be
an effective way to mobilize the shoulder.
Understanding the main cause of the problem is at the
base of an effective and decisive treatment. The
osteopath makes some diagnostic test to the patient,
then he decides what muscular group and/or articulations
are involved according to the limitation in the
movements and the type of pain. Very important is also
the collection of information on the lifestyle and
habits of the patient: pain could be more acute because
of daily movements which, in time, worsen the situation
(for ex. in the car, turning the trunk and stressing the
shoulder to get the bag from the back seat).
Once the diagnosis has been made, the osteopathic manual
treatment concerns both the painful area and the
referred parts, in a way not to excessively stress the
body. A treatment which concerns only the painful area
could be counterproductive. In case of an inflammation
with acute pain, the osteopath can at most look for an
antalgic position to give the patient some relief and
facilitate a resting position of the joint. This can be
already considered a therapy.
In a chronic phase, this therapy is well combined with
thermal mud-bath therapy (especially in case of
calcification), massages, rehabilitation in thermal
water, especially with the consequences of post-trauma
and articular functional rehabilitation.
There is no single manoeuvre for each single problem:
understanding if the treatment is perceived by the body
or if a different approach must be tried, is up to the
osteopath’s sensitivity. The response of the body to the
work done by the osteopath arrives after a phase of
adaptation by the body to the input, lasting about 21
days.
Remedies from the past:
In the situation of
inflammation resulting in acute pain, apply
compresses of cool water and vinegar; this
is an anti-inflammatory method. Be careful
of ice compresses: it is a great
“anesthetic” but it is also a
vasoconstrictor and freezes, and therefore
after a temporary relief the pain can
increase.
In a chronic situation, and non- pulsating
pain, with contractures at the ligaments,
Doctor Antonello recommends lukewarm
compresses of water and salt. If the
compresses are applied before the
osteopathic treatment, the treatment allows
the tensed structures to be more easily
mobilized.
The editorial
office thanks, for the in depth information:
Doctor Fabiano Antonello Surgeon
Expert in osteopathic manual medicine
Primary doctor at the
Hotel
Terme Dolomiti
We have asked some experts and specialists to help us improve our understanding of the causes and therapeutic
modalities of shoulder pains. In the following pages you
can find some explanations and suggestions which cannot
replace medical advice, but they try to highlight the
importance of prevention and prompt action by calling a
specialist who can locate the cause of the problem and
who can give the most suitable therapeutic solutions.
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At the spa for two
How wonderful and complicated is
a relationship! Let’s try to
understand how to create moments
for two rich in cuddles and
communication perhaps while you
are plunged into thermal water.
