In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .
Immediate changes in pressure pain sensitivity after thoracic spinal manipulative therapy in patients with subacromial impingement syndrome: A randomized controlled study.
BACKGROUND Thoracic SMT can improve symptoms in patients with subacromial impingement syndrome . However , at this time the mechanisms of SMT are not well established . It is possible that changes in pain sensitivity may occur following SMT . OBJECTIVES To assess the immediate pain response in patients with shoulder pain following thoracic spinal manipulative therapy ( SMT )  using pressure pain threshold ( PPT ) , and to assess the relationship of change in pain sensitivity to patient-rated outcomes of pain and function following treatment . DESIGN R and omized Controlled Study . METHODS Subjects with unilateral subacromial impingement syndrome ( n = 45 ) were r and omly assigned to receive treatment with thoracic SMT or sham thoracic SMT . PPT was measured at the painful shoulder ( deltoid ) and unaffected regions ( contralateral deltoid and bilateral lower trapezius areas ) immediately pre- and post-treatment . Patient-rated outcomes were pain ( numeric pain rating scale - NPRS ) , function ( Pennsylvania Shoulder Score - Penn ) , and global rating of change ( GROC ) . RESULTS There were no significant differences between groups in pre-to post-treatment changes in PPT ( p ≥ 0.583 ) nor were there significant changes in PPT within either group ( p ≥ 0.372 ) following treatment . NPRS , Penn and GROC improved across both groups ( p < 0.001 ) , but there were no differences between the groups ( p ≥ 0.574 ) . CONCLUSION There were no differences in pressure pain sensitivity between participants receiving thoracic SMT versus sham thoracic SMT . Both groups had improved patient-rated pain and function within 24 - 48 h of treatment , but there was no difference in outcomes between the groups
In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .