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Duncan Chiropractic Group Newsletter

Manual Therapy Effective For Shoulder Dysfunction

Gary Peters, D. C. - March Issue
Gary Peters, D. C.

A study published recently in the Annals of Internal Medicine has found "manual therapy" in conjunction with 'usual medical care' to be much more effective for shoulder dysfunction and pain than usual medical care alone.

Researchers in The Netherlands noted significant improvements in recovery, severity of complaint, shoulder pain and shoulder disability with the addition of a 12-week course of manual therapy.

Usual medical care (control group) included information, advice, and therapy. Control group therapy included prescriptions for oral analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, and/or physiotherapy as needed.

Patients in the intervention group received usual care and manipulative therapy that included specific manipulations (low-amplitude, high-velocity thrust techniques) and specific mobilizations (high-amplitude, low-velocity thrust techniques) "to improve overall joint function and decrease any restrictions in movement at single or multiple segmental levels in the cervical spine and upper thoracic spine and adjacent ribs." This is an important point, as this study provides evidence that by utilizing spinal manipulation to address shoulder pain and dysfunction, problems in the shoulder (and other extremities) can be addressed through manipulation of the spine.

Data on the patients were collected during and at the end of the treatment period (at six and 12 weeks) and during the follow-up period (at 26 and 52 weeks). At the completion of care (12 weeks), "43% of the intervention group and 21% of the control group reported full recovery." After a full year (52 weeks), "approximately the same difference in recovery rate (17 percentage points) was seen between groups."

The differences in results showed substantial improvement for those patients receiving manipulative therapy.

The authors point out the fact that this is the first study of its kind: "To our knowledge, this is the first trial to focus on the effectiveness of adding manipulative therapy for the cervicothoracic spine and the adjacent ribs to usual medical care for treatment of shoulder symptoms."