Abstract

Objective:

To determine the effects of applying a force to C5 of the spine by a mechanically assisted instrument (MAI) in patients with referred shoulder pain.

Summary of Background Data:

Manipulating C5 of the spine is a chiropractic treatment for referred shoulder pain, there are no clinical trials evaluating its efficacy. Outcome measures were patient ranked questionnaires and independent examiner findings. One hundred and twenty-five patients were diagnosed with referred shoulder pain of cervical origin; sixty-five were in the treatment cohort and sixty in the placebo cohort.

Methods:

This was a prospective, randomized, double-blind, placebo-controlled trial assessing the effects of applying a force to C5 by an MAI to patients with referred shoulder pain. The treatment cohort had the MAI set at the maximum setting to transmit a force into the spine; the placebo cohort had the MAI turned off. Primary outcome measures were frequency and severity of extreme shoulder pain obtained via a patient-reported questionnaire; secondary outcome measures were patient ranked pain and functional outcomes, as well as the examiner, assessed the range of motion and strength. Assessment procedures were completed at 24 weeks post-treatment and data were analyzed with intent to treat protocol.

Results:

There was a reduction in the frequency but not the severity of extreme shoulder pain in the treatment cohort, average ranking reducing from weekly to monthly (p < 0.05). Patients treated with the MAI had 10 N (p = 0.04) better internal rotation strength after 6 months post-treatment. No differences with any other outcome measures between the two cohorts at the 24 week study period.

Conclusion:

The major effect of applying an MAI to the level of C5 of the spine in referred shoulder pain is improved shoulder strength for internal rotation in this randomized double-blinded clinical trial.


Author information: Hardas GM, Murrell GA. Orthopaedic Research Institute, St George Hospital Clinical School, Faculty of Medicine, UNSW, Sydney, Australia.

Epub ahead of print

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