Shoulder Pain and Regional Interdependence: Contributions of the Cervicothoracic Spine

Abstract

Copyright: © 2014 Mintken P. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Shoulder pain is common, with a reported prevalence between 2033% [1]. Additionally, the incidence of shoulder pain in the general population appears to be increasing [2]. The prognosis for patients with a new onset of shoulder pain is generally poor, with recovery rates of only 49-59% at an 18-month follow-up [3,4]. Recurrence rates are also high, as Rekola et al. [5] reported that 1 in 4 individuals with shoulder or neck pain will experience at least one episode of recurrence within 12 months of onset. In the year 2000, the direct costs for the treatment of shoulder pain in the United States topped $7 billion, [6] and Kuijpers et al. [7] reported that 74% of the total costs for managing shoulder pain are attributable to individuals with persistent or recurrent symptoms. Shoulder pain can be challenging for both patients and health care providers. A study by Ostor et al. [8] on non-specific shoulder pain reported that 77% were diagnosed with more than one shoulder problem. Many shoulder pathologies present with similar examination findings, but vary widely in their outcomes and require different intervention approaches [9]. Specific diagnosis and classification can be difficult, as de Winter et al. [10] reported only moderate agreement on the classification of shoulder disorders. Given that shoulder pain is difficult to accurately diagnose, Dinant et al. [11] argue that we need a shift from diagnostic to prognostic research.