In this RCT, Dutch researchers studied the effectiveness of manipulative therapy for the shoulder girdle in addition to usual medical care for relief of shoulder pain and dysfunction. A total of 150 patients with shoulder symptoms and dysfunction of the shoulder girdle received usual medical care from their GPs in general practices in The Netherlands. Only the intervention group received additional manipulative therapy, up to six treatment sessions in a 12-week period. Patient-perceived recovery, severity of the main complaint, shoulder pain, shoulder disability and general health were assessed during and at the end of the treatment period (at 6 and 12 weeks) and during the follow-up period (at 26 and 52 weeks). No significant differences were found between study groups during treatment. After completion of treatment (12 weeks), 43% of the intervention group and 21% of the control group reported full recovery. After 52 weeks, approximately the same difference in recovery rate (17 percentage points) was seen between groups. During the intervention and follow-up periods, a consistent between-group difference in the severity of the main complaint, shoulder pain and disability, and general health favoured additional manipulative therapy. The authors conclude that manipulative therapy for the shoulder girdle in addition to usual medical care accelerates recovery of shoulder symptoms but notes that sample size was small and assessment of endpoints subjective.