As shoulder injuries become more prevalent in our active population, a debilitating condition known as frozen shoulder syndrome (FSS) is frustrating patients and health care practitioners alike. But a Texas chiropractor is pioneering a way of assessing and treating the syndrome that is offering relief not seen before.
In what is also known as shoulder adhesive capsulitis, the connective tissue surrounding the shoulder joint becomes stiff and inflamed. It greatly restricts the movement of the shoulder and upper arm while causing what can be described as excruciating pain when trying to move your arm or shoulder. Pain is usually constant — worse at night — and, because it is associated with extremely restricted movement, it can make even the smallest task impossible.
Frozen shoulder syndrome affects as many as a million Canadians a year, mainly people over 40, with a higher incidence in women. There have been many theories about what causes FSS, but no definitive answer.
“Reputable websites, like that of the Mayo Clinic in the United States, suggest an association between FSS and recent surgery, a past sporting injury, recent shoulder immobilization due to injury or surgery, thyroid problems, cardiovascular problems, diabetes mellitus, and Parkinson’s disease,” says Dallas chiropractor Frances Murphy. Some researchers suggest that because there is a higher incidence in women, there could be a hormonal component to the cause. None of these theories have been proven.
Murphy calls his method OTZ, named after the binary code in the computer language — one to zero. The technique involves a unique analysis and manipulation of the joint between the back of the skull (occiput) and the first cervical vertebra of the neck on which the occiput rests.
The analysis involves a specific form of motion palpation of the articulation of the first cervical vertebra and the occiput, as well as X-ray analysis and postural distortion of the head resting on the neck. Manipulation of this joint is obtained through a technique not previously taught to healthcare providers, including chiropractors. The manipulation is not a traditional chiropractic neck adjustment.
Murphy discovered a misalignment of the occiput as it sits on top of the first cervical vertebra of the neck can cause an alteration to the proper reverse “C” shape of the neck (lordosis) which keeps the head forward.
This alteration causes a tethering to the brainstem of the upper neck which, in turn, restricts blood supply and tension to cranial nerve 11 in the brain (the spinal accessory nerve). Murphy has found this condition interferes with the ability of the patient to raise their arm.
What follows are all the classic collection of symptoms seen in a typical case of frozen shoulder syndrome — pain and loss of range of motion of the shoulder. By removing the interference on cranial nerve 11 thru a specific OTZ manipulation, the function of the shoulder is restored. Quite often, the improved range of motion and decrease in pain is immediate and dramatic.
Traditional treatments for FSS can include anti-inflammatory and pain medications, cortisone injections, physiotherapy, massage, acupuncture, soft tissue manipulation, and even soft tissue manipulation while under anesthesia.
These procedures are lengthy, painful and can carry on for up to two years with no guarantee of a cure.
Murphy says, while we must treat the shoulder joint and the soft tissue around it, the focus for treating FSS is where the skull meets the first cervical vertebra.
Until Murphy’s research and methods, healthcare practitioners had been missing the most important link in the resolution of FSS. OTZ treats frozen shoulder syndrome as a neurological condition, not an orthopedic condition.
If we employ the OTZ method of thinking, there likely has to be a series of repetitive events that cause this shoulder problem. These could include sports injuries, motor vehicle accidents and poor posture in the workplace, particularly in people sitting for long hours at a computer.
Murphy has successfully treated hundreds of patients and has been training doctors from around the world, including myself, to broaden the accessibility of this treatment for people suffering FSS.
Dr. Jay Shephard, D.C., is clinical director and principal chiropractor and active release techniques provider of Shephard Health in Calgary, Alta.