Management of the Unilateral Shoulder Impingement Syndrome
Authors: Christopher Leib
Journal: Annals of Internal Medicine (2015)

Letters3 February 2015Management of the Unilateral Shoulder Impingement SyndromeChristopher Leib, DPT, CSCS, Cert MDT, COMTChristopher Leib, DPT, CSCS, Cert MDT, COMTFrom Pain Relief and Physical Therapy, Havertown, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5043 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:On the surface, Rhon and colleagues' thoughtful study (1) shows the effectiveness of subacromial corticosteroid injection and manual physical therapy (MPT) to treat the shoulder impingement syndrome (SIS). However, several factors complicate the comparison of MPT with medical intervention and perhaps limit this study's otherwise valuable contribution.First, the manual therapy approach used was well-described in Rhon and colleagues' study (1) and elsewhere (2). However, physical therapists in clinical practice typically assess the presence and quality of symptoms in relation to patient movement and position, not according to a pathoanatomical diagnosis, such as SIS. Therefore, including MPT ...References1. Rhon DI, Boyles RB, Cleland JA. One-year outcome of subacromial corticosteroid injection compared with manual physical therapy for the management of the unilateral shoulder impingement syndrome: a pragmatic randomized trial. Ann Intern Med. 2014;161:161-9. [PMID: 25089860] doi:10.7326/M13-2199 LinkGoogle Scholar2. Rhon DI, Boyles RE, Cleland JA, Brown DL. A manual physical therapy approach versus subacromial corticosteroid injection for treatment of shoulder impingement syndrome: a protocol for a randomised clinical trial. BMJ Open. 2011;1:e000137. [PMID: 22021870] doi:10.1136/bmjopen-2011-000137 CrossrefMedlineGoogle Scholar3. Cook CE, Showalter C, Kabbaz V, O'Halloran B. Can a within/between-session change in pain during reassessment predict outcome using a manual therapy intervention in patients with mechanical low back pain? Man Ther. 2012;17:325-9. [PMID: 22445052] doi:10.1016/j.math.2012.02.020 CrossrefMedlineGoogle Scholar4. Luime JJ, Koes BW, Miedem HS, Verhaar JA, Burdorf A. High incidence and recurrence of shoulder and neck pain in nursing home employees was demonstrated during a 2-year follow-up. J Clin Epidemiol. 2005;58:407-13. [PMID: 15862727] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Christopher Leib, DPT, CSCS, Cert MDT, COMTAffiliations: From Pain Relief and Physical Therapy, Havertown, Pennsylvania.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L14-0450. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOne-Year Outcome of Subacromial Corticosteroid Injection Compared With Manual Physical Therapy for the Management of the Unilateral Shoulder Impingement Syndrome Daniel I. Rhon , Robert B. Boyles , and Joshua A. Cleland One-Year Outcome of Subacromial Corticosteroid Injection Compared With Manual Physical Therapy for the Management of the Unilateral Shoulder Impingement Syndrome Daniel I. Rhon , Robert B. Boyles , and Joshua A. Cleland Management of the Unilateral Shoulder Impingement Syndrome Daniel I. Rhon , Robert B. Boyles , and Joshua A. Cleland Management of the Unilateral Shoulder Impingement Syndrome Daniel I. Rhon , Robert B. Boyles , and Joshua A. Cleland Metrics 3 February 2015Volume 162, Issue 3Page: 237KeywordsConflicts of interestCorticosteroid therapyDisclosureInflammationShoulder impingementShoulders ePublished: 3 February 2015 Issue Published: 3 February 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...