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Journal of Physical Medicine and Rehabilitation

ISSN: 2690-0297

Original Research Open Access
Volume 7 | Issue 1 | DOI: https://doi.org/10.33696/rehabilitation.7.051

Treatment for Central Sensitization and Shoulder Pain Using Systemic Manual Therapy (SMT)

Gustavo T Sato1, Adi Halili1,*
  • 1Halili Physical Therapy, Tucson, Arizona, USA
+ Affiliations - Affiliations

Corresponding Author

Adi Halili, Halilipt@msn.com

Received Date: July 11, 2025

Accepted Date: August 02, 2025

Citation:

Sato GT, Halili A. Treatment for Central Sensitization and Shoulder Pain Using Systemic Manual Therapy (SMT). J Phys Med Rehabil. 2025;7(1):98–105.


Copyright: © 2025 Sato GT, et al. 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.

Abstract

Objective: The purpose of this study is to test a hypothesized treatment for the central sensitization component of shoulder pain, which is based on Halili’s proposed temporal model for central sensitization.

Design: Cohort retrospective multivariate analysis.

Methods: This study uses The Halili physical therapy statistical analysis tool (HPTSAT) to evaluate the average rate of improvement in shoulder pain and overall associated symptoms in 734 patients after provision of 552 protocol combinations of Systemic Manual Therapy.

Results: Among the 734 patients in the study 429 (58%) reported improved specific changes related to shoulder pain. The average improvement in shoulder pain was 1.51 points (p<0.001). Forty-one combinations containing 16 distinct protocols passed the HPTSAT criteria to demonstrate better treatment effect than optimal standard of care (oSOC) including 5 of the protocols proposed to treat the central sensitization component.

Discussion and Conclusion: This study supports the treatment approach for central sensitization (CS) hypothesized in the temporal model for central sensitization (TMCS) when treating shoulder pain.

Keywords

Shoulder pain, Temporal model for central sensitization, Systemic manual therapy, Barral, Fascial counterstrain, Integrative manual therapy

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