Changes in Shoulder Pain and Disability After Thrust Manipulation in Subjects Presenting With Second and Third Rib Syndrome

Abstract

This group of patients with shoulder pain secondary to second and third rib syndrome who received upper thoracic and upper rib HVLA thrust manipulations showed significant reductions in pain and disability and improvement in perceived level of recovery.

Spinal Manipulation and Electrical Dry Needling in Patients With Subacromial Pain Syndrome: A Multicenter Randomized Clinical Trial

“…shoulder pain and SAPS. 5,17,73 Nevertheless, a recent multicenter randomized clinical trial 53 (n = 227) found that the addition of acupuncture or electroacupuncture was no more effective than exercise alone in the treatment of individuals with SAPS. However, in contrast to the current study, Lewis et al 53 included patients with full-thickness and/or massive irreparable rotator cuff tears, and therefore used a much broader and nonspecific definition of SAPS than other trials 2,7,31,32,47,63,68 and diagnostic guidelines.…”

“…The TMEDN group received an impairment-based manual therapy approach, using thrust manipulation directed primarily to the lower cervical (C4-C6), cervicothoracic (C7-T3), midthoracic (T4-T9), and upper-rib (1-3) articulations, as described in previous studies 5,[17][18][19]74,79,81 and in APPENDIX A (available at www.jospt. org).…”

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

“…Studies, using single or short interventions to the thoracic spine and the upper ribs show conflicting immediate- [22][23][24]26] and short-term results [13,25] in patients with shoulder pathology. Thrust manipulation techniques seemed to show immediate effect in studies not using a control intervention, [13,22,25,26], but were not superior when compared to sham manipulation [23,24].…”

“…Thrust manipulation techniques seemed to show immediate effect in studies not using a control intervention, [13,22,25,26], but were not superior when compared to sham manipulation [23,24]. Of these studies, only Mintken et al examined pain and shoulder ROM as outcomes.…”

“…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.…”