Some Factors Predict Successful Short-Term Outcomes in Individuals With Shoulder Pain Receiving Cervicothoracic Manipulation: A Single-Arm Trial

Abstract

The identified prognostic variables will allow clinicians to make an a priori identification of individuals with shoulder pain who are likely to experience short-term improvement with cervical and thoracic spine manipulation. Future studies are necessary to validate these findings.

What Effect can Manual Therapy have on a Patient’s Pain Experience?

“…Findings from single arm studies provide conflicting results for relationships between pre-intervention psychological factors and shortterm clinical outcomes following MT joint based techniques [64][65][66]. Findings from randomized clinical trials also provide conflicting results for this relationship.…”

Immediate effects of cervical unilateral anterior-posterior mobilisation on shoulder pain and impairment in post-operative arthroscopy patients

“…Lateral glide cervical mobilisation techniques have been successfully used in the treatment of shoulder dysfunction [11][12][13] and appear most effective for outcomes including pain, ROM [12,13], and general perceived recovery [13]. While improvements to shoulder flexion [13] and abduction [12] have been described, Mintken et al used no control intervention in their study examining flexion [13], and McClatchie et al only measured abduction ROM [12] thereby limiting comparisons with each other and the present study.…”

“…These lateral (or transverse) glide mobilisations at the lower cervical segments provided short-term improvement to pain, ROM and external rotation strength in patients with insidious painful shoulders [13], patients with a painful arc during abduction [12], and in neck patients with concomitant shoulder muscle weakness [11]. In contrast, unilateral posterior-anterior mobilisations have not shown significant improvements in shoulder impingement patients [21].…”

“…Improvement of shoulder function has been shown in applying cervical mobilisation directed to facilitate physiological coronal plane motion [11][12][13]. These lateral (or transverse) glide mobilisations at the lower cervical segments provided short-term improvement to pain, ROM and external rotation strength in patients with insidious painful shoulders [13], patients with a painful arc during abduction [12], and in neck patients with concomitant shoulder muscle weakness [11].…”

“…These effects are purportedly elicited by afferents in skin, muscle, joint, and neurovascular structures in response to the mechanical stimulus, producing centrally-mediated (especially periaqueductal grey) pain inhibition, reduced mechanosensitivity, either sympathetic excitation or inhibition, and either increased or decreased ROM [7][8][9][10]. Effects have been shown to extend remotely to influence the shoulder [11][12][13] and elbow [14][15][16][17]. In addition to intrinsic shoulder structures with causation for shoulder pain [18][19][20], extrinsic structures like the cervical [11,12,21] and thoracic spines [22][23][24][25], and upper ribs [26] have been implicated.…”