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 .
Muscle trigger points and pressure pain hyperalgesia in the shoulder muscles in patients with unilateral shoulder impingement: a blinded, controlled study
Our aim was to describe the differences in the presence of trigger points ( TrPs ) in the shoulder muscles and to investigate the presence of mechanical hypersensitivity in patients with unilateral shoulder impingement and healthy controls . Twelve patients with strictly unilateral shoulder impingement and 10 matched controls were recruited .  TrPs in the levator scapula , supraspinatus , infraspinatus , subscapularis , pectoralis major , and biceps brachii muscles were explored . TrPs were considered active if the local and referred pain reproduced the pain symptoms and the patient recognized the pain as a familiar pain . Pressure pain thresholds ( PPT ) were assessed over the levator scapulae , supraspinatus , infraspinatus , pectoralis major , biceps brachii , and tibialis anterior muscles . Both explorations were r and omly done by an assessor blinded to the subjects ’ condition . Patients with shoulder impingement have a greater number of active ( mean ± SD : 2.5 ± 1 ; P < 0.001 ) and latent ( mean ± SD : 2 ± 1 ; P = 0.003 ) TrPs when compared to controls ( only latent TrPs , mean ± SD : 1 ± 1 ) . Active TrPs in the supraspinatus ( 67 % ) , infraspinatus ( 42 % ) , and subscapularis ( 42 % ) muscles were the most prevalent in the patient group . Patients showed a significant lower PPT in all muscles when compared to controls ( P < 0.001 ) . Within the patient group a significant positive correlation between the number of TrPs and pain intensity ( rs = 0.578 ; P = 0.045 ) was found . Active TrPs in some muscles were associated to greater pain intensity and lower PPTs when compared to those with latent TrPs in the same muscles ( P < 0.05 ) . Significant negative correlations between pain intensity and PPT levels were found . Patients with shoulder impingement showed widespread pressure hypersensitivity and active TrPs in the shoulder muscles , which reproduce their clinical pain symptoms . Our results suggest both peripheral and central sensitisation mechanisms in patients with shoulder impingement syndrome
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 .