Tag Archives: pain relief

Chiropractic Management of Shoulder Pain

16 Mar

By some estimates, shoulder complaints affect nearly half of the adult population in a
year, driving many to chiropractic offices looking for a conservative, non-surgical solution.
While back pain and neck pain are the primary reasons patients seek chiropractic care, at least
one study found that 12% of chiropractic visits in a week may involve shoulder issues. How
would a chiropractor manage a shoulder complaint?
The shoulder complex itself is made up of four separate articulations—the glenohumeral
joint, the acromioclavicular joint, the sternoclavicular joint, and the scapulothoracic joint—that
work together to support the wide range of motion available to the arm. These joints, along with
the tendons, ligaments, muscles, and other soft tissues involved in upper extremity movement,
are all at risk of injury. When assessing treatment, the first step would be to conduct a thorough
examination to properly diagnose which components of the shoulder are contributing to the
patient’s chief complaints.
Because examination findings will vary, the specific treatment approach for a given
patient will be unique. However, in a general sense, multiple therapies are typically combined
with the goal of restoring normal movement to the affected joint(s). This may include manual
therapies (manipulation, mobilization, and soft tissue techniques), stabilization exercises,
stretches, physiotherapy modalities, and anti-inflammatory measures such as ice. Activities at the
extreme ranges of motion may be limited in the short term, with a gradual return to normal
activities within pain tolerances.
The shoulder does not exist in isolation, and several studies suggest that dysfunction in
the thoracic spine can affect movement of the scapula, which in turn can limit motion in other
aspects of the shoulder. In particular, a February 2024 study found that including mid-back
chiropractic adjustments in a treatment plan for adhesive capsulitis (frozen shoulder) improved
outcomes with respect to shoulder pain, disability, and function, and a January 2025 systematic
review and meta-analysis that included ten clinical trials found that thoracic spinal manipulative
therapy also improved outcomes for patients with subacromial impingement syndrome.
Chiropractic care has been demonstrated to benefit patients with various shoulder
complaints, and the treatments used are well supported in clinical guidelines as first-line
approaches. However, it should be noted that these conditions can have a difficult recovery
process, even if the patient undergoes surgery, and it can take months or even a year to restore
normal function to the affected joints.

Brent Binder, M.S.,D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

(717) 697-1888

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In-Office and At-Home Neck Pain Management

9 Mar

Neck pain is estimated to affect approximately 30–50% of the adult population in the
United States each year, making it second only to low back pain as a primary reason patients
seek chiropractic care. The goal of chiropractic care for neck pain is to help restore normal joint
motion and function in the cervical spine, a process that is often a collaborative effort between
care delivered during office visits and self-care performed by the patient between visits.
During office visits, neck pain patients are commonly treated with manual therapies as a
primary intervention. High-velocity, low-amplitude spinal manipulation—sometimes
accompanied by an audible pop or crack—is the technique most commonly associated with
chiropractic care. Chiropractors are also trained in lower-force approaches, including
mobilization techniques and soft tissue therapies. Treatment plans may involve more than one
type of manual therapy depending on the tissues involved, patient presentation, and clinician
judgment.
In-office care may also include cervical traction, particularly when nerve irritation is
suspected to be contributing to symptoms. To assist with short-term symptom relief, patients
may receive adjunctive therapies such as electrical stimulation (e.g., TENS), therapeutic
ultrasound, low-level laser therapy, or heat or cold therapy. In some practices, massage therapy
provided by an on-site massage therapist may also be incorporated.
Between visits, patients are encouraged to take an active role in their recovery.
Continuing to pursue normal activities within pain tolerance helps prevent muscle
deconditioning (which can increase the risk of chronic pain) and supports joint health by
promoting nutrient exchange through movement. When muscle weakness or imbalance is
identified—which is common in neck pain—patients may be instructed in specific exercises to
perform regularly as time allows. Additional guidance may include recommendations for
sleeping positions, pillow selection, and temporary work or activity modifications to support
recovery. Anti-inflammatory strategies, including dietary modifications and selected
supplements, may also be discussed when appropriate.
Once pain and functional limitations reach maximal improvement, patients are typically
released from active care. Some may be advised to schedule wellness or maintenance visits on an
as-needed or periodic basis, along with continuing neck-healthy habits in daily life. Together,
these strategies may help reduce the likelihood of future episodes or allow a subsequent neck
pain episode to be addressed earlier before it interferes with normal activities or quality of life.

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The Pain Mechanisms of Chronic Low Back Pain

4 Mar

In simple terms, chronic low back pain is pain affecting the lumbar spine region that lasts
longer than three months. However, chronic low back pain is not simply acute (new) low back pain
that has failed to resolve. Rather, it often reflects an overlap of two or even three distinct pain
mechanisms, each of which may need to be addressed to achieve an optimal outcome: nociceptive,
neuropathic, and nociplastic pain.
Nociceptive low back pain arises from injury or irritation of non-neural tissues, including
muscles, ligaments, tendons, and joints. This type of pain is typically localized and may feel achy,
throbbing, or sharp with movement or certain positions. During a physical examination, a doctor of
chiropractic can often reproduce symptoms with palpation or specific movements. The term nonspecific low back pain is commonly used to describe pain that is predominantly nociceptive in
nature.
Neuropathic low back pain is caused by damage or disease affecting the nervous system
itself. In the context of chronic low back pain, this is most often associated with disk herniation
compressing a nerve root, degenerative changes (such as arthritis) narrowing the spaces through
which nerves travel, or postsurgical nerve injury. This form of pain is commonly described as
burning, shooting, or electric and often radiates along the course of the affected nerve. Patients may
also experience non-painful neurological symptoms, including numbness, tingling, weakness, or
altered reflexes.
Nociplastic low back pain typically develops over time in response to an initial injury or
episode of pain. This pain is characterized by altered pain processing within the nervous system and
is often associated with widespread or shifting pain patterns, heightened pain intensity, and increased
sensitivity to touch or movement. Patients with nociplastic low back pain may restrict movement and
daily activities out of fear of worsening their condition (kinesiophobia), describe pain in amplified or
distressing terms, feel poorly equipped to manage their symptoms, and commonly report poor sleep
and elevated stress. Coexisting conditions such as headaches, irritable bowel syndrome, or
fibromyalgia are also more prevalent in this population.
Because chronic low back pain often includes a combination of nociceptive, neuropathic, and
nociplastic components, treatment approaches must be individualized. A multimodal care plan may
include manual therapies, targeted exercises, physical modalities, and anti-inflammatory strategies
aimed at restoring normal motion and function to affected nerves, joints, muscles, tendons, and
ligaments. In addition, chiropractors may employ pain education and graded activity exposure to
address nociplastic factors and help patients regain confidence in movement. When appropriate,
referral to a medical physician or specialist may also be indicated—all with the goal of helping the
patient return to normal activities of daily living in the safest and most pain-free manner possible.

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Excessive Smartphone Use Can Be a Pain in the Neck

18 Feb

Since their introduction and rapid adoption in the mid-2000s, smartphones have become an
integral part of daily life—not only by consolidating multiple technologies into a single device, but
also by helping us stay connected with family, friends, clients, and colleagues. However, alongside
these benefits, a growing body of evidence points to significant downsides. Excessive smartphone
use has been linked to poorer mental health—particularly among teens and young adults—and may
also negatively affect physical health.
Most notably, smartphone use typically involves prolonged downward gaze. While this
posture may seem harmless at first, over time the body adapts by rounding the shoulders and shifting
the head forward from its normal centerline. Beyond its impact on physical appearance, forward head
posture places increased strain on the muscles and tendons of the neck and upper back that work to
support the head. This pattern has been colloquially referred to as “tech neck” or “text neck.” In
addition to neck pain, forward head posture may increase the risk of headaches as well as pain in the
thoracic and lumbar regions of the spine. Moreover, screen time is often sedentary time, and
excessive device use is associated with prolonged sitting and reduced physical activity—factors that
can elevate overall chronic disease risk.
A 2017 study found that smartphone use tends to peak during young adulthood, with
approximately 1 in 5 university students meeting criteria for smartphone addiction—defined as a
pattern of compulsive smartphone use marked by loss of control, psychological distress when use is
restricted, and continued use despite negative impacts on daily functioning, relationships, or health.
Women were found to be at greater risk than men. In addition, up to half of young adults exhibit
problematic smartphone-related behaviors, suggesting that these devices exert a substantial influence
on this population.
To help curb excessive smartphone use, consider the following strategies: turn off nonessential notifications; establish phone-free times (such as before bed) and keep the phone in another
room to reduce temptation; avoid bringing the phone into the restroom; use “Do Not Disturb” mode
during focused tasks; install third-party apps to track and limit daily screen time; delete time-wasting
apps; rediscover hobbies to fill leisure time; keep a paper book on hand for passive commutes or
waiting periods; and tell friends and family about your goals so they can provide accountability and
support.
Finally, if you are experiencing chronic spinal pain related to prolonged smartphone use,
consider consulting a doctor of chiropractic. Chiropractors can provide in-office care to help reduce
pain and disability, as well as prescribe simple exercises and posture strategies that can be performed
between visits to help restore healthy spinal alignment.
Brent Binder, D.C. 4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

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The Neck and Low Back Connection

15 Jan

When a patient seeks chiropractic care for a condition like neck pain or low back pain, it’s natural to assume the underlying cause is located in the region where the patient feels symptoms. But this isn’t always the case. Sometimes, the primary or contributing factor to the patient’s chief complaint can be elsewhere in the body. A July 2024 study involving patients with cervical myelopathy helps illustrate this point.

Cervical myelopathy is a condition in which the spinal canal narrows due to a variety of potential causes—age-related degeneration, cervical spinal stenosis, herniated disks, trauma, rheumatoid arthritis, ossification of the posterior longitudinal ligament, or even tumors, infections, or congenital narrowing—and compresses the spinal cord. While neck pain is common, irritation of the spinal cord can produce downstream effects in the areas those nerve fibers reach. In this study, which involved 786 individuals with cervical myelopathy, two-thirds also reported low back pain.

Following treatment for cervical myelopathy, about half of those with concurrent low back pain experienced meaningful improvement in both lower back pain and function, and some even reported complete resolution. This suggests that for roughly half of these patients, the issue in their neck was a major contributing factor to their low back symptoms.

Beyond cervical myelopathy itself, several soft-tissue systems span the entire spine—including fascia, long spinal muscles, and ligamentous structures—making it possible for restrictions or dysfunction in the upper spine to influence symptoms in the lower spine. The reverse is also true: issues affecting the feet, ankles, knees, hips, or low back can lead to compensatory postural changes that place additional strain on the neck as the body works to keep the eyes level.

This helps underscore the importance of evaluating the whole patient rather than narrowing attention to the immediate area of complaint—something doctors of chiropractic are trained to do. The good news is that the hands-on care chiropractors provide can often help resolve these contributing issues, and when necessary, your doctor of chiropractic will coordinate with allied healthcare providers to support the best possible outcome.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

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Conservative Treatment for Hip Bursitis

12 Jan

Hip bursitis most often refers to trochanteric bursitis, an inflammation of the trochanteric bursa, a small fluid-filled sac located on the outer side of the hip. The primary symptom is pain on the outside of the hip near the greater trochanter—the bony bump at the top of the femur. The pain may be sharp, dull, or throbbing and often worsens with activities that load the hip, such as walking, climbing stairs, or lying on the affected side. Other possible symptoms include swelling and tenderness around the hip, redness (less common), difficulty walking or running, and limping. What role can chiropractic play in managing this condition?

While hip bursitis can result from direct trauma, infection, or complications following hip surgery—which are red flags requiring medical or emergency evaluation—the majority of cases are musculoskeletal in nature and can be managed conservatively. Common contributors include overuse or repetitive stress (friction between the iliotibial band and the greater trochanter), biomechanical abnormalities that alter gait mechanics, prolonged pressure on the hip from poor sitting posture, lumbar spine or sacroiliac joint dysfunction, or tight/overactive musculature that increases tension on the iliotibial band and irritates the bursa. Many of these factors overlap and can work together to inflame the hip bursa.

When a patient presents for chiropractic evaluation, the chiropractor will assess for postural and biomechanical changes beginning with the feet, as excessive pronation, flat feet, knee valgus (“knocking in”), and pelvic imbalance can contribute to functional leg-length differences—one of the factors associated with hip bursitis. The exam typically includes orthopedic tests to assess hip range of motion and pain provocation patterns. Imaging such as X-ray or MRI may be ordered when needed to exclude other pathology.

Short-term management focuses on reducing inflammation through rest, activity modification, and sometimes dietary changes or supplements with anti-inflammatory properties. Applying an ice pack for 15–20 minutes or performing brief ice massage (3–4 minutes) can help reduce pain and swelling. The main treatment goal is to correct the underlying mechanical issues irritating the bursa. This may involve manual therapy to improve mobility in the hip and related joints, targeted stretching and strengthening exercises to address muscle imbalances, and even a heel lift to reduce leg-length inequality, if needed. Because hip bursitis has multiple contributing factors, the specific treatment plan is individualized for each patient. If a patient does not respond to conservative care, they may be referred to their medical physician or a specialist for further evaluation to determine whether more invasive options—such as corticosteroid or platelet-rich plasma injections, or in rare cases surgery—may be appropriate.

As with many conditions, prevention is key. Maintaining a healthy weight, following an anti-inflammatory diet, stretching the hip muscles regularly, using proper posture and movement strategies during daily activities, keeping the core strong, and staying physically active all support hip health. Periodic chiropractic checkups can also help identify biomechanical issues early—before they become painful or interfere with normal function.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

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