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 1st, 1990 to April 18th, 2013. STUDY SELECTION: Randomized controlled trials (RCTs), cohort and case-control studies were eligible. Random pairs of independent reviewers screened 1,470 of 1,760 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.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher