An epidemiologic survey of shoulder pain in chiropractic practice in australia.
OBJECTIVE
This survey investigated the demographic characteristics of the responding practitioners, the prevalence of shoulder pain symptoms seen in weekly chiropractic practice, the sources of shoulder pain, the chiropractor-diagnosed prevalence of shoulder clinical syndromes, and the management strategies for Australian chiropractors.


METHODS
A survey was created by the authors consisting of questions seeking demographic information from the respondents, shoulder syndrome, and shoulder management information. The survey was mailed to every chiropractic practitioner based in the Australian state of New South Wales (general population 6.8 million in 2005). Contact details were derived from Yellow Pages online listings.


RESULTS
One thousand thirty-seven surveys were mailed to New South Wales-based chiropractors, with 192 (21%) returning a completed survey. The prevalence of shoulder pain symptoms as reported by the practitioners was 12% of the total weekly patients, with the major cause of symptoms related to overuse (32%). The most prevalent working diagnosis of shoulder pain was shoulder impingement syndrome (13%), followed by impingement syndrome with rotator cuff tendinosis (17%), impingement syndrome without rotator cuff tendinosis (14%), and chiropractic shoulder subluxation (12%). Shoulder pain is managed with a combination of manipulation, mainly diversified technique (81%), peripheral joint manipulation (82%), and various soft tissue strategies used by 92% of practitioners. Rehabilitation strategies were also used by 89% of practitioners with a main emphasis placed on rotator cuff strengthening.


CONCLUSIONS
The results suggest a moderate prevalence of shoulder pain in clinical practice with the most prevalent structure involved being the rotator cuff tendon. Most practitioners use a multimodal therapeutic treatment approach in managing disorders of the shoulder.
Pribicevic
Mario
M
Private practice of chiropractic, Harbord NSW, Australia.
Pollard
Henry
H
Bonello
Rod
R
D001315:Australia / Q000453:epidemiology; D002684:Chiropractic / Q000379:methods* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D026882:Manipulation, Chiropractic / Q000379:methods* / Q000706:statistics & numerical data; D010147:Pain Measurement; D017288:Pain Threshold; D015995:Prevalence; D012720:Severity of Illness Index; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D020069:Shoulder Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D016896:Treatment Outcome