Manipulative assessment and treatment of the shoulder complex: case reports.
OBJECTIVE
To describe a unique method of evaluation and a conservative management plan for patients with shoulder dysfunction of mechanical origin. Possible causes for this clinical presentation and a brief review of the literature are offered.


METHODS
In the 3 cases described here, symptoms included acute shoulder pain, limitation of movement, positive orthopedic tests, palpable tenderness, muscle spasm and muscle weakness. The 3 cases all resulted in differing diagnoses.


RESULTS
Following the use of a proposed joint dysfunction isolation test, thrusting forms of manual adjusting procedures, electrical modalities and soft tissue therapy were applied. Three cases representing different common shoulder problems (an acute episode of a chronic problem, a progressive problem resulting in capsulitis, and a occult problem associated with a motor vehicle accident) responded favorably to treatment.


CONCLUSIONS
There is the need for a non-surgical, conservative approach to treatment of shoulder problems before considering the more aggressive treatment approaches that carry greater iatrogenic risks. The patients' signs and symptoms responded to a unique method of evaluation and manipulative therapy when other approaches had failed. The risk/benefit ratio suggests that conservative care be considered a potential option for similar conditions.
Donahue
Thomas
T
Private Practice of Chiropractic, Montana.
Bergmann
Thomas
T
Donahue
Sara
S
Dody
Michael
M
J Rheumatol. 1996 Dec;23(12):2043-8
8970039
Man Ther. 1997 Aug;2(3):123-131
11440525
BMJ. 1998 Jan 31;316(7128):354-60
9487172
J Orthop Sports Phys Ther. 1996 Aug;24(2):66-77
8832469
Med J Aust. 1986 Feb 17;144(4):196-200
3511358
J Bone Joint Surg Am. 1997 May;79(5):738-48
9160947
Man Ther. 2000 May;5(2):63-71
10903581
J Rheumatol. 1995 Apr;22(4):727-32
7791172
J Am Osteopath Assoc. 1946 Feb;45:249
21011845
J Orthop Sports Phys Ther. 1993 May;17(5):212-24
8343779
Phys Ther. 1995 Sep;75(9):803-12
7659740