Adhesive capsulitis (AC) is a common and disabling shoulder condition seen in
physical therapy, and there is no clear consensus as to the best treatment approach. Recently there has been emerging evidence that
manual therapy directed at the thoracic spine may be beneficial for patients with
shoulder pain; however, this has not been examined specifically in patients with AC. The purpose of this paper is to present the case of 59-year-old female referred to
physical therapy with a diagnosis of AC. The patient presented with complaints of left
shoulder pain and significant limitations in range of motion (ROM) and upper extremity function. The initial treatment included exercises and
manual therapy directed at the glenohumeral and scapulothoracic joints, and after 10 visits only minimal progress had been made. Further examination revealed mobility and ROM deficits in the thoracic spine, and
manual therapy directed at this region was incorporated into her treatment. After the first session of thoracic spine
manual therapy (TSMT) a 25 degree improvement was noted in active shoulder flexion. After four total visits of TSMT substantial improvements in
pain, ROM, and function were noted compared to those made during the first 10 visits. This case adds to the emerging evidence that
manual therapy directed at the thoracic spine should be considered for patients with
shoulder pain.