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. CLINICAL FEATURES: 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. INTERVENTION AND OUTCOME: 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.
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. CLINICAL FEATURES: 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. INTERVENTION AND OUTCOME: 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.
Authors: C H van Den Ende; P M Rozing; B A Dijkmans; J A Verhoef; E M Voogt-van der Harst; J M Hazes Journal: J Rheumatol Date: 1996-12 Impact factor: 4.666