Given how often I see patients whose non-spinal pain is related to their spine, I make sure to investigate the spine as a possible contributor or cause. As I’ve said before, that investigation varies in time based on the case.
If I read a study on patients diagnosed with “patellofemoral pain syndrome” or “shoulder impingement” and there is no mention of clinically looking into the effect spinal movements have on the person’s complaints, I take that study with a grain of salt. I use the word “clinically” on purpose: you cannot rule in or out spinal involvement solely with an image. At least 25% of people’s shoulder and knee pain I see is actually a spine problem, addressed with moving the spine.
I also say “probably” in this post on purpose. If an orthopedic study looks at people who have traumatically fractured their tibias, that is a different ball game. Most orthopedic problems, however, aren’t obvious traumas. -- Laura
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