Citation

Yu H, Côté P, Shearer HM, Wong JJ, Sutton DA, Randhawa KA, Varatharajan S, Southerst D, Mior SA, Ameis A, Stupar M, Nordin M, van der Velde GM, Carroll L, Jacobs CL, Taylor-Vaisey AL, Abdulla SY, Shergill Y. Phys. Ther. 2014; 95(3): 306-318.

Affiliation

Y. Shergill, BSc, DC, Department of Graduate Studies, CMCC, and Department of Anesthesia, the Ottawa Hospital, Ottawa, Canada.

Copyright

(Copyright © 2014, American Physical Therapy Association)

DOI

10.2522/ptj.20140361

PMID

25394425

Abstract

BACKGROUND: Shoulder pain is a common musculoskeletal condition in the general population. Passive physical modalities are commonly used to treat shoulder pain. However, previous systematic reviews report conflicting results.

PURPOSE: To evaluate the effectiveness of passive physical modalities for the management of soft tissue injuries of the shoulder. DATA SOURCES: MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from January 1(st), 1990 to April 18(th), 2013. STUDY SELECTION: Randomized controlled trials (RCTs), cohort and case-control studies were eligible. Random pairs of independent reviewers screened 1470 of 1760 retrieved articles after removing 290 duplicates. Twenty-two articles were eligible for critical appraisal. We critically appraised the eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Of those, 11 studies had a low risk of bias. DATA EXTRACTION: The lead author extracted data from low risk of bias studies and built evidence tables. A second reviewer independently checked the extracted data. DATA SYNTHESIS: We synthesized the findings of low risk of bias studies according to principles of best evidence synthesis. We found that pre-tensioned tape, ultrasound and interferential current are not effective to manage shoulder pain. However, diathermy and corticosteroid injections lead to similar outcomes. Low-level laser therapy provides short-term pain reduction for subacromial impingement syndrome. Extracorporeal shock-wave therapy is not effective for subacromial impingement syndrome but it provides benefits for persistent shoulder calcific tendonitis. LIMITATIONS: Non-English studies excluded.

CONCLUSIONS: Most passive physical modalities do not benefit patients with subacromial impingement syndrome. However, low-level laser therapy is more effective than placebo or ultrasound for subacromial impingement syndrome. Similarly, shock-wave therapy is more effective than sham for persistent shoulder calcific tendinitis.

Language: en