McClatchie Lynda, Laprade Judi, Martin Shelley, Jaglal Susan B, Richardson Denyse, Agur Anne
Graduate Department of Rehabilitation Sciences, University of Toronto, 500 University Avenue, Toronto, Ontario, Canada.
Man Ther. 2009 Aug;14(4):369-74. doi: 10.1016/j.math.2008.05.006. Epub 2008 Aug 26.
Generalized shoulder pain is a common problem that is difficult to treat and frequently recurrent. The asymptomatic cervical spine must be ruled out as a cause of any shoulder pain, as it can have a similar presentation to an isolated shoulder disorder. Previous studies have shown that lateral cervical glide mobilizations to the asymptomatic cervical spine at C5/6 can affect peripheral pain, but none have examined shoulder pain. A randomized, blinded, placebo-controlled, cross-over trial was used to examine the immediate effects of cervical lateral glide mobilizations on pain intensity and shoulder abduction painful arc in subjects with shoulder pain. Twenty-one subjects received interventions of both cervical mobilization and placebo over two sessions. Pain intensity using a visual analog scale (VAS) and painful arc were assessed prior to and following application of cervical mobilization or placebo intervention. Evaluation of cervical mobilization revealed the shoulder abduction painful arc (12.5 degrees +/-15.6 degrees, p=0.002) and shoulder pain intensity (1.3+/-1.1cm, p<0.001) were significantly decreased. The results of this study suggest that any immediate change in shoulder pain or active shoulder range of motion following cervical mobilizations indicate that treatment directed toward the asymptomatic cervical spine may expedite recovery.
广泛性肩部疼痛是一个常见问题，难以治疗且经常复发。必须排除无症状颈椎作为任何肩部疼痛的病因，因为它可能具有与孤立性肩部疾病相似的表现。先前的研究表明，对C5/6无症状颈椎进行颈椎侧方滑动松动术可影响外周疼痛，但尚无研究考察对肩部疼痛的影响。一项随机、双盲、安慰剂对照的交叉试验用于研究颈椎侧方滑动松动术对肩部疼痛患者疼痛强度和肩部外展疼痛弧的即时影响。21名受试者在两个疗程中接受了颈椎松动术和安慰剂两种干预。在应用颈椎松动术或安慰剂干预之前和之后，使用视觉模拟量表（VAS）评估疼痛强度，并评估疼痛弧。颈椎松动术评估显示，肩部外展疼痛弧（12.5度±15.6度，p=0.002）和肩部疼痛强度（1.3±1.1厘米，p<0.001）显著降低。本研究结果表明，颈椎松动术后肩部疼痛或主动肩部活动范围的任何即时变化表明，针对无症状颈椎的治疗可能会加速恢复。
