Manual Therapy Plus Exercise Improves Long-Term Outcomes for Subacromial Shoulder Pain

Subacromial (shoulder) pain is common, and very annoying for patients. Often aching, sharper (or ‘pinchy’) with movement, it can be quite disabling. As chiropractors, we normally use a combination of manual therapy and exercise…a good idea, according to this week’s review of a recent randomized trial!

Subacromial shoulder pain is defined as pain arising from structures within the subacromial space, including the rotator cuff tendons, bursa and long head of the biceps. It is the most common cause of MSK-related shoulder pain. Unfortunately, recovery can be limited, with 40-50% of patients developing recurrent pain. Resistance exercise is recommended as first line treatment and is known to improve patient reported outcomes to varying degrees.

Manual therapy is generally recommended in conjunction with resistance training, but the effects are inconsistent. The goal of this study was to assess the additive effects of manual therapy with a resistance exercise program compared to exercise alone. The primary outcomes evaluated were patient-reported pain and disability. Measures of global effect of treatment, satisfaction and additional health care utilization post-discharge were secondary outcomes. The authors hypothesized that manual therapy would enhance the benefits of resistance exercise.

This week’s Research Review: “Manual Therapy Plus Exercise Improves Long-Term Outcomes for Subacromial Shoulder Pain”

This paper was published in the JOSPT Open (2024)

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