Effectiveness of thoracic manipulations on shoulder pain: A Case Report
Original Editor - Rucha Gadgil Top Contributors - Rucha Gadgil
Abstract[edit | edit source]
The objective of the study was to explore the effects of manipulations to the cervicothoracic junction on clinical outcomes in patients with rotator cuff pathology. Multiple reports in recent peer-reviewed literature state that manipulative techniques aimed at the thoracic spine used in conjunction with exercise produce superior benefits in patients with shoulder impingement and/or rotator cuff pathology. The quality of evidence in this area is limited and further research is warranted to determine the extent and nature of the relationship between thoracic manipulation and shoulder pain.
F.B, a 58 year-old male, was admitted to physical therapy after a two-month history of shoulder pain. Interventions were aimed at strengthening the periscapular musculature and rotator cuff, improving range of motion, decreasing pain, and returning to a pre-morbid level of injury. Manipulations to the cervicothoracic junction were performed in conjunction with exercise interventions. Outcomes included, changes in the VAS (visual analog pain scale), patient rating of overall improvement, and Quick DASH measurement. At the time of discharge, F.B. was determined to have a successful outcome based on decreased pain to 2/10 on the VAS and reports of 60% overall improvement. These tools are both found to be valid and reliable when used as acute subjective measures.
This case report indicates manipulations directed to the thoracic spine may be a useful adjunct to pragmatic treatment for patients with shoulder pain.
