Shoulder pain is a common complaint that drives patients to a doctor’s office, including  chiropractic clinics. It’s estimated that about one-third of the population will experience shoulder pain at some point, with subacromial pain syndrome accounting for approximately two-thirds of these cases. Subacromial pain syndrome arises from issues in the subacromial space, located between the acromion (a bony prominence of the shoulder blade) and the rotator cuff tendons. This condition is often associated with inflammation, irritation, or damage to the tendons or bursa, leading to pain during lifting and overhead shoulder movements, reduced range of motion, and discomfort at night, especially when lying on the affected shoulder.

Rather than resulting from a single injury, subacromial pain syndrome is often caused by the accumulation of microinjuries and degenerative changes due to factors such as aging, repetitive activities, poor posture, improper mechanics, and shoulder muscle imbalances. While surgical intervention may be an option in severe cases, treatment guidelines emphasize prioritizing non-surgical approaches, as these may achieve similar results without the risks, costs, and recovery time associated with surgery. A combination of manual therapies and shoulder-specific exercises is well-supported in the literature, though a recent study found that a more comprehensive approach may yield additional benefits.

In an October 2024 study, researchers divided patients with subacromial pain syndrome into two groups. Both groups received treatment that included manual therapies and exercises aimed at improving the motion of the glenohumeral joint (the ball-and-socket joint of the shoulder complex). However, the second group also received scapular muscle stretching and strengthening exercises, scapular motor control retraining, thoracic spine mobilization, and postural correction. While both groups showed similar improvements immediately after treatment, the comprehensive group demonstrated faster and more significant progress at a six-month follow-up. These findings suggest that incorporating mid-back and scapular-focused care may be essential for achieving long-lasting relief in patients with subacromial pain syndrome.

The good news is that doctors of chiropractic are trained to evaluate the whole patient rather than focusing solely on the area of chief complaint. Addressing contributing factors in adjacent areas, such as the scapula and thoracic spine, can significantly enhance treatment outcomes and help patients achieve lasting relief.