Expert: Scott F. Gillman, DC, DACBSP - 12/16/2010

Question
Dear Scott F. Gillman,

I ' ve had for few years a clicking big toe with mild pain especially when I click it a lot during the day.
The pain is rare because I tend to walk with shoes or slipper.
The sound is always here and systematic when I walk.
This happened after hurting my toe on a wall years ago.
The click happens when I elevate the toe and seems to me

I heard that a chiropractor could maybe adjust it.
Is a surgery necessary for this ?
What should I do to fix this : do I have to see a chiropractor, an orthopedic surgeon, an osteopathe ?
Or do I let this as it is ?


Also, if you allow me I have as well an impingement in my left shoulder when doing certain movement with my left arm like putting a glass of water from the table to my mouth.

I did scapular exercices for a while but with no result and I 'm wondering if the exercices somewhat don't maintain a possible inflammation causing a vicious circle thing strenghtening a part of the shoulder but still inflamming it.

I heard acupuncture could heal this ?

What would you recommand for this, should I see an osteopathe, a chiropractor,an acupuncturist ?


I thank you in advance for you time and your help.

Best regards,

Answer
Sherry,

I'm not sure what you have wrong with your toe.  Keep in mind that this in an internet exchange and I have only limited information;  I would suggest you find a good chiropractor and he/she could examine and provide a few weeks of treatment to see if it helps.   Especially in regards to shoulder impingement syndrome, there are different kinds of impingement and thus different ways to go about treating it.  Often you have to alleviate any tissue adhesions around the shoulder and also make sure the neck and middle back joints are mobile.  Then you must focus on exercising the muscles that hold your shoulder blades back (scapular stabilization exercises).  Then, lastly, you exercise the shoulder rotator cuff muscles.  This would be a good place to start.  Also, if you have an anatomic barrier to healing, such as calcification of a tendon or bursa, no exercise is going to help...  This is where x-ray can be helpful in diagnosing the cause of your shoulder condition.   First things first: get a good physical exam.  Some chiropractors are excellent and clearly would be the best choice for examination and treatment over the orthopedist or osteopath, and some chiropractors are quite embarrassing in their lack of knowledge and skills.  Find a good one.   

'Best,

Dr. G