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Jeff Remsburg


Shoulder Pain; Adhesive Capsulitis; McKenzie Method; Mechanical Diagnosis and Therapy; Manipulation; Instrument-Assisted Soft-Tissue Mobilization


Objective: Adhesive capsulitis of the shoulder is often a debilitating and long-lasting condition even with traditional treatment.  The purpose of this case report is to discuss examination, intervention and clinical outcomes of a patient with pain that closely resembled adhesive capsulitis.    
Case Description: The patient was a 59-year-old retired female with history of multiple hereditary exostoses (MHE).  She had a 1-month history of insidious onset right shoulder pain that had been worsening.  At the initial visit, she reported pain (5-9/10 on the numerical pain rating scale), limitations with range of motion and decreased daily functions (Disabilities of Arm, Shoulder Hand score was 57.5%).  Examination revealed severely limited active and passive range of motions in all directions of her right shoulder. Treatment included utilization of the McKenzie Method of mechanical diagnosis and therapy (MDT), thoracic manipulation, and instrument-assisted soft-tissue mobilization over the shoulder.
Outcomes:  After 5 visits in a 2-week period, she reported no pain or limitations.  Examination revealed right shoulder motion to be pain-free and equal to the left shoulder. On a follow-up phone call 2 weeks later, her DASH score was 0%. 
Conclusion: This patient demonstrated rapid improvement in pain, function and range of motion following examination and treatment utilizing MDT, IASTM and chiropractic manipulation. While a single case is not enough to warrant cause-effect relationships, it seems this treatment approach may be beneficial for shoulder pain presenting as adhesive capsulitis.


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