CHIROPRACTIC AND MCKENZIE METHOD ASSESSMENT AND TREATMENT OF A PATIENT WITH A SHOULDER DERANGEMENT MIMICKING ADHESIVE CAPSULITIS

Main Article Content

Jeff Remsburg

Keywords

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

Abstract

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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References

1 . Luime JJ, Hendriksen IJM, Burdof A et al. Prevalence and incidence of shoulder pain in the general population; a systemic review. Scand J Rheumatol 2004;33:73-81
2 . Jain TK, Sharma NK. The effectiveness of physiotherapeutic interventions in treatment of frozen shoulder/adhesive capsulitis: A systemic review. J Back Musculoskelet Rehabil 2014;27:247-273
3 . Le HV, Lee SJ, Nazarian A et al. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow 2017;9:75-84
4 . Shaffer B, Tibone JE, Kerlan RK. Frozen shoulder: a long-term follow up. J Bone Joint Surg Am 1992;74(5):738-746
5 . Hand C, Clipshaw K, Rees JL, Carr AJ. Long-term outcome of frozen shoulder. J Shoulder Elbow Surg 2008;17(2):231-236
6 . May S, Ross J. The McKenzie classification system in the extremities: a reliability study using McKenzie assessment forms and experienced clinicicians. J Manip Physiol Ther 2009;32:556-563
7 . Abady AH, Rosedal R, Overend TJ et al. Inter-examiner reliability of diplomats in the mechanical diagnosis and therapy system in assessing patients with shoulder pain J Man Manip Ther 2014;22(4):199-205
8. May S, McKenzie R. The human extremities mechanical diagnosis and therapy. Waikanae, Wellington, New Zealand: Spinal Publications New Zealand Ltd.; 2002
9 . Long A, Donelson R, Fung T. Does it matter which exercise? A randomized control trial of exercise for low back pain. Spine 2004;29(23):2593-2602
10 . Walser RF, Meserve BB, Boucher TR. The effectiveness of thoracic spine manipulation for the management of of musculoskeletal conditions: A systematic review and meta-analysis of randomized clinical trials. J Man Manip Ther 2009;17(4):237-246
11 . Peek AL, Miller C, Heneghan NR. Thoracic manual therapy in the management of non-specific shoulder pain: a systematic review. J Man Manip Ther 2015;23(4):176-187
12 . Strunce JB, Walker MJ, Boyles RE et al. The immediate effects of thoracic spine and rib manipulation on subjects with primary complaints of shoulder pain. J Man Manip Ther 2009;17(4):230-236
13 . Wainner R, Whiteman J, Cleland J et al. Regional interdependence: a musculoskeletal examination model whose time has come. J Orthop Sports Phys Ther 2007;37(11):658-660
14 . Bialosky JE, Bishop MD, George SZ. Regional interdependence: a musculoskeletal examination model whose time has come [letters to the editor-in-chief]. J Orthop Sports Phys Ther 2008;38:159-160
15 . Carey-Longmani, MT, Hammer. WI. Graston Technique In: Hammer,WI, ed. Functional soft-tissue examination and treatment by manual methods. Boston, MA: Jones and Bartlett; 2007:589-625
16 . Loghmani MT, Warden SJ. Instrument-assisted cross-fiber massage accelerates knee ligament healing. J Orthop Sports Phys Ther 2009;39:(7):506-514
17 . Cheatham SW, Lee M, Cain M et al. The efficacy of instrument assisted soft tissue mobilization: a systematic review. J Canadian Chiropr Assoc 2016;60(3):200-211
18 . Laudner K, Compton DB, McLoda TA et al. Acute effects of instrument assisted soft tissue mobilization for improving posterior shoulder range of motion in collegiate baseball players. Int J Sports Phys Ther 2014;9(1):1-7
19 . Hudak PL, Amadio PC, Bombardier C, The Upper Extremity Collaborative Group (UECG) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. Am J Ind Med 1996;29(6):602–608
20 . May SJ, Rosedale R, A survey of the McKenzie classification system in the extremities: prevalence of the mechanical syndromes and preferred loading strategy., Phys Ther 2012;92(9):1175-1186
21 . Bowser A, Swanson BT. Evaluation and treatment of a patient diagnosed with adhesive capsulitis classified as a derangement using the McKenzie Method: A case report. Int J Sports Phys Ther 2016;11(4):627-636