Physiotherapy Interventions for shoulder pain: Cochrane review summary.

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The following offers a snippet of the freely available Cochrane Review which can be found here…

Unfortunately small sample sizes, variable methodological quality and heterogeneity in terms of physiotherapy interventions results, physiotherapy intervention employed and length of follow up of RCT of PT interventions results in little overall evidence to guide treatment.

Overview
  • Prevalence of Shoulder disorders 7-36% of the population. (Lundberg, 1969)
  • Athletic Shoulder Injuries: 8-13% (Hill, 1983)
  • Peak prevalence: 56-60 year olds (Allander 1974, Ingemar 1993)
Physio Aims in Shoulder Pain
  • The aim is to relieve pain
  • Promote healing
  • Reduce muscle spasms
  • Increase joint range and strengthen weakened muscles and ultimately to prevent and treat functional impairment (Lee 1973).
Summary
  • Pulsed Electromagnetic Field for rotator cuff disease in the short term (1 trial, Binder 1984)
  • Ultrasound and Pulsed Electromagnetic Field for Calcific tendinitis. (2 trials Ebenbichler 1999; Dal Conte 1990)
  • In general, ultrasound is of no additional benefit over and above exercise alone (1 trial Winters 1997/9)
  • For rotator cuff disease, corticosteroid injections are superior to physiotherapy interventions (4 trials, van der Windt 1998; Berry 1980; Winters 1997/9; Bulgen 1984)
  • No evidence that physiotherapy interventions alone is of benefit for Adhesive Capsulitis (1 trial Dacre1989)
  • Supervised exercise regime is of benefit in the short and long term for mixed shoulder disorders and rotator cuff disease (Brox 1993/7; Ginn 1997).
  • Exercise for rotator cuff disease with additional benefit from exercise plus mobilisation (2 trials, Bang 2000; Conroy 1998).
  • Laser for adhesive capsulitis in the short term, but not for rotator cuff disease (4 trials,Taverna 1990; England 1989; Saunders 1995;Vecchio 1993)

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