title: Chiropractic management of a 46-year-old type 1 diabetic patient with upper crossed syndrome and adhesive capsulitis.
abstract: OBJECTIVE
  To discuss the treatment of a patient with type 1 diabetes presenting with chronic neck and shoulder pain by using chiropractic manipulation and an active rehabilitation program with emphasis on correcting postural imbalances.
  
  
  METHODS
  A 46-year-old insulin dependant (type1) diabetic female presented with neck and right shoulder pain of 6 to 8 months duration. Her history included similar left-sided complaints 2 years prior at which time she underwent 3 months of rehabilitation at a local medical center, which improved her condition. Over time her pain resolved but the residuals of restricted left shoulder range of motion remained. The patient had postural changes consisting of forward head posture, rounded shoulders and internally rotated arms.
  
  
  RESULTS
  Treatment included spinal manipulation, ultrasound and active rehabilitation consisting of at home exercises initially and followed with in office low-tech rehabilitation. Rehabilitation was primarily aimed at improving postural abnormalities, muscle imbalances and abnormal movement patterns. The patient improved with this course of treatment.
  
  
  CONCLUSIONS
  Chiropractic care including active rehabilitation may be helpful in treating diabetic patients suffering from chronic neck and shoulder problems.
authors.affiliation: Private practice of chiropractic, Valli Chiropractic.
authors.forename: Joseph
authors.initials: J
authors.lastname: Valli
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