Physical Examination of the Cervical Spine and Shoulder Girdle in Patients with Shoulder Complaints

Objective: To look for differences in mobility in randomly selected patients without shoulder complaints depending on age, gender and left- or right-handedness; to investigate in the patient group whether specific differences exist, depending on the diagnosis made or the afflicted side; and to detect differences between the findings on the mobility examination of the cervical and cervicothoracic spine in patients with shoulder complaints compared with the healthy population.

Design: Comparative study.

Method: The physical examination findings after inclusion and after 26 wk of 101 shoulder patients were compared with those of 75 randomly selected patients without shoulder complaints and adjusted for age and gender.

Results: In the population of patients without shoulder complaints, the mobility in the cervical and upper thoracic spine was found to decrease with aging. Significant differences were found between the healthy and the afflicted population at the time of inclusion as well as after 26 wk, even though the majority of patients felt cured at that time. With all types of shoulder complaints, functional disorders in the shoulder girdle were found in which, at the time of inclusion, the emphasis was on pain and, after 26 wk, on restricted motion. Thus, functional disorders in the cervical spine, the higher thoracic spine and the adjoining ribs are not extrinsic causes of shoulder complaints, but an integral part of the intrinsic causes of shoulder complaints.

Conclusion: Further study is needed to determine if this finding explains the high recurrence rate of shoulder complaints. It may be advisable to include the treatment of functional disorders of the shoulder girdle in treatment of patients with shoulder complaints.