ArticleThe Journal of manual & manipulative therapy2020
A study exploring the prevalence of Extremity Pain of Spinal Source (EXPOSS).
Article in The Journal of manual & manipulative therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Screening of the thoracolumbar spine is almost completely absent in trials evaluating conservative management for sacroiliac joint pain: a systematic review of 43 randomized controlled trials.The Journal of manual & manipulative therapy · 2026Pooled it
- Effectiveness of cervicothoracic and thoracic manual physical therapy in managing upper quarter disorders - a systematic review.The Journal of manual & manipulative therapy · 2022Pooled it
- Investigation of the interaction between shoulder and cervical vertebral pathologies in isolated shoulder pain: clinical and morphological aspects.Journal of orthopaedic surgery and research · 2026Article
- Mechanical diagnosis and therapy in chronic postpartum isolated coccygeal pain: a case report.The Journal of the Canadian Chiropractic Association · 2026Article
- Inter-rater reliability of Mechanical Diagnosis and Therapy (MDT) in evaluating and classifying chronic pelvic pain syndrome.The Journal of manual & manipulative therapy · 2025Article
- The prevalence of subclassification-based diagnoses when considering cervical contribution in shoulder pain patients: a secondary analysis from a previous research.The Journal of manual & manipulative therapy · 2025Article
- Cervical Spine Screening Based on Movement Strategies Improves Shoulder Physical Variables in Neck-Related Shoulder Pain Patients: A Secondary Analysis from an Observational Study.Journal of clinical medicine · 2025Article
- PHYSICAL ASSESSMENT IN SURFERS: GUIDELINES FOR HEALTH PROFESSIONALS - PART 1 UPPER QUARTER.Acta ortopedica brasileira · 2025Article
- Patellar Tendinopathy Responding to Spinal Treatment: A Case Report Using Mechanical Diagnosis and Therapy.International journal of sports physical therapy · 2025Article
- Research Priorities in the Mechanical Diagnosis and Therapy Among Diploma Therapists: An International Delphi Study.Cureus · 2024Article
- The influence of directional preference on lateral patellar dislocation: a case report.The Journal of manual & manipulative therapy · 2023Article
- Diagnosis and conservative management of sural neuropathy: a case report.The Journal of the Canadian Chiropractic Association · 2023Article
- Exploring indicators of extremity pain of spinal source as identified by Mechanical Diagnosis and Therapy (MDT): a secondary analysis of a prospective cohort study.The Journal of manual & manipulative therapy · 2022Article
- Upper extremity special issue.The Journal of manual & manipulative therapy · 2022Article
- Author's response to Anthony Halimi and David Poulter's letter to the editor regarding 'A study exploring the prevalence of extremity pain of spinal source (EXPOSS)'.The Journal of manual & manipulative therapy · 2020Article
- Lack of evidence for stating 'spinal source' of pain in EXPOSS study.The Journal of manual & manipulative therapy · 2020Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate the proportion of patients that present with isolated extremity pain who have a spinal source of symptoms and evaluate the response to spinal intervention.
methodsParticipants (n = 369) presenting with isolated extremity pain and who believed that their pain was not originating from their spine, were assessed using a Mechanical Diagnosis and Therapy differentiation process. Numerical Pain Rating Scale, Upper Extremity/Lower Extremity Functional Index and the Orebro Questionnaire were collected at the initial visit and at discharge. Global Rating of Change outcomes were collected at discharge. Clinicians provided MDT 'treatment as usual'. A chi-square test examined the overall significance of the comparison within each region. Effect sizes between spinal and extremity source groups were calculated for the outcome scores at discharge.
resultsOverall, 43.5% of participants had a spinal source of symptoms. Effect sizes indicated that the spinal source group had improved outcomes at discharge for all outcomes compared to the extremity source group. DISCUSSION: Over 40% of patients with isolated extremity pain, who believed that their pain was not originating from the spine, responded to spinal intervention and thus were classified as having a spinal source of symptoms. These patients did significantly better than those whose extremity pain did not have a spinal source and were managed with local extremity interventions. The results suggest the spine is a common source of extremity pain and adequate screening is warranted to ensure the patients ́ source of symptoms is addressed.
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