Thoracic spine manipulation in patients with shoulder pain
The following randomised controlled trial demonstrated that thoracic spinal manipulative therapy (SMT) did not cause any significant improvement in patient-reported pain or function in patients with subacromial impingement.
Previous research has alluded towards thoracic SMT improving pain and disability in individuals with subacromial pain syndrome. Nevertheless, the mechanics by which these improvements occur are not fully understood. The following study investigated changes in thoracic kinematics, excursion and scapular kinematics due to thoracic SMT, and compared patient-reported pain and function in those with subacromial impingement.
52 patients were randomly assigned to receive a single session of thoracic SMT or sham-SMT. The authors found no significant differences between either group in changes post-intervention for thoracic kinematics or excursion, shoulder kinematics, and patient-reported outcomes.
In conclusion, whilst patient-reported outcomes improved in both groups, these were not correlated with meaningful changes to thoracic or scapular motion. Immediate changes in symptoms of subacromial impingement syndrome following thoracic SMT may not be due to biomechanical changes at the thoracic spine or scapula.
> From: Kardouni et al., J Orthop Sports Phys Ther (2015) (Epub ahead of print). All rights reserved to Journal of Orthopaedic & Sports Physical Therapy. Click here for the Pubmed summary.