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Clavicular Dysfunctions: An Osteopathic Approach to Neck, Shoulder, and Chest Pain

Journal: The AAO Journal Date: 2025/06, 35(2):Pages: 18. doi: Subito , type of study: case report

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/2/article-p13.xml)

Keywords:

case report [725]
chest pain [20]
clavicular dysfunction [1]
collarbone [1]
female [629]
neck pain [175]
OMT [3779]
osteopathic manipulative treatment [3799]
shoulder pain [29]
women [582]

Abstract:

Introduction: The clavicle provides a key link between the axial skeleton and the arm, making it reasonable to suspect that a dysfunction of the sternoclavicular (SC) joint may cause manifestations in surrounding parts of the body. Research has shown that cervical and thoracic manipulations can lead to improvement in shoulder pain, but research studying the link between clavicular dysfunctions and neck, chest, and shoulder pain is limited. Case: A 59-year-old female, presented with chronic left-sided neck and shoulder pain and one month of worsening, severe chest pain localized to the left SC joint. The patient also presented with dizziness when lying on her left side. Physical exam on initial encounter revealed a very prominent and tender left SC joint, and on Osteopathic exam a severely horizontally extended and moderately adducted left clavicle as well as hypertonic cervical musculature were found. Results: Following initial OMT treatment with direct and indirect techniques, the patient returned for follow-up three months later and denied experiencing chest or shoulder pain since, however, she was still experiencing left-sided neck pain. Repeat evaluation showed continued cervical muscular hypertonicity but a much-improved prominence of the clavicle, an almost resolved tenderness of the SC joint, as well as only a mildly horizontally extended and an almost-resolved adducted left clavicle. Discussion: Addressing clavicular dysfunctions almost completely resolved the patient’s chest and shoulder pain, and upon both OMT treatments, O.V. reported immediate relief to her symptoms and an overall improved quality of life. A limitation to this study is the lack of generalizability to the general population. Further research is needed to find a link between using OMT to treat clavicular dysfunctions and relieving chest, shoulder, and neck pain.


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