Neck or Shoulder? Establishing Consensus for Spine Screening in Patients With Shoulder Pain: An International...

Area of Science:

• Orthopedics
• Physical Therapy
• Musculoskeletal Disorders

Background:

• Lack of consensus exists for spinal screening in shoulder pain patients.
• Understanding the spine's role in shoulder pain is vital for effective management.

Purpose of the Study:

• To explore the spine's role in shoulder pain.
• To develop recommendations for spinal screening in shoulder pain patients.

Main Methods:

• Modified Delphi study with an international expert panel of physical therapists.
• Consensus achieved on clinical reasoning, history, and physical examination items.
• Aiken Validity Index ≥0.7 defined consensus.

Main Results:

• Consensus reached on 30 items across clinical reasoning, history, and physical examination.
• Spinal and shoulder disorders can coexist and influence each other.
• Radiating pain identified as a key indicator of spinal involvement.

Conclusions:

• Experts agreed on screening criteria: distal symptoms, neck pain history, symptom changes with neck movement, neuropathic symptoms.
• Assessment of cervical/cervicothoracic movements and specific tests (Spurling, symptom modification) are recommended.
• Findings impact clinical practice by informing prognosis and management, and research by ensuring homogenous study samples.