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Physiotherapy interventions for shoulder pain

  1. Sally Green1,*,
  2. Rachelle Buchbinder2,
  3. Sarah E Hetrick3

Editorial Group: Cochrane Musculoskeletal Group

Published Online: 16 JUL 2008

Assessed as up-to-date: 23 FEB 2003

DOI: 10.1002/14651858.CD004258

Database Title

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How to Cite

Green S, Buchbinder R, Hetrick SE. Physiotherapy interventions for shoulder pain. Cochrane Database of Systematic Reviews 2003, Issue 2. Art. No.: CD004258. DOI: 10.1002/14651858.CD004258.

Author Information

  1. 1

    Monash University, School of Public Health & Preventive Medicine, Melbourne, Victoria, Australia

  2. 2

    Department of Epidemiology and Preventive Medicine, Monash University, Monash Department of Clinical Epidemiology at Cabrini Hospital, Malvern, Victoria, Australia

  3. 3

    University of Melbourne, Centre of Excellence in Youth Mental Health, Orygen Youth Health Research Centre, Centre for Youth Mental Health, Melbourne, Victoria, Australia

*Sally Green, School of Public Health & Preventive Medicine, Monash University, Monash Medical Centre, Locked Bag 29, Clayton, Melbourne, Victoria, 3168, Australia. sally.green@monash.edu.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 16 JUL 2008

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Bang 2000 {published data only}
  • Bang M, Deyle G. [Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome]. Journal of Orthopeadic & Sports Physical Therapy 2000;30(3):126-137.
Berry 1980 {published data only}
  • Berry H, Fernandes L, Bloom B, Clark RJ, Hamilton EB. [Clinical study comparing acupuncture, physiotherapy, injection and oral anti-inflammatory treatment in shoulder-cuff lesions]. Current Medical Research & Opinion 1980;7(121-6).
  • Fernandes L, Berry H, Clark RJ, Bloom B, Hamilton EBD. [Clinical study comparing acupuncture, physiotherapy, injection and oral anti-inflammatory therapy in shoulder cuff lesions]. Lancet 1980;Jan:208-209.
Binder 1984 {published data only}
Brox 1993/7 {published data only}
  • Bohmer A, Staff P, Brox J. [Supervised exercises in relation to rotator cuff disease (impingement syndrom stages I and II): a treatment regimen and its rationale]. Physiotherapy Theory & Practice 1998;14:93-105.
  • Brox J, Staff P, Ljunggren A, Brevik J. [Arthroscopic surgery compared with supervised exercises in patients with rotator cuff disease]. British Medical Journal 1993;307(6909):899-903.
  • Brox JI, Gjengedal E, Uppheim G, Bohmer AS, Brevik JI, Ljuggren AE, Staff PH. [Arthroscopic surgery versus supervised exercises in patients with rotator cuff disease (stage II impingement syndrome): A prospective, randomised, controlled study in 125 patients with a 2 1/2 year follow-up]. Journal of Shoulder & Elbow Surgery 1999;8(2):102-111.
Bulgen 1984 {published data only}
  • Bulgen D, Binder A, Hazleman B, Dutton J, Roberts S. [Frozen shoulder: prospective clinical study with an evaluation of three treatment regimes]. Annals of the Rheumatic Diseases 1984;43:353-360.
Conroy 1998 {published data only}
  • Conroy DE, Hayes KW. [The effect of mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome]. Journal of Orthopaedic & Sports Physical Therapy 1998;28(1):3-14.
Dacre1989 {published data only}
Dal Conte 1990 {published data only}
  • Dal Conte G, Rivoltini P, Combi F. [Trattamento della periartrite calcarea di spalla con campi magnetici pulsanti: studio controllato]. La Riabilitazione 1990;23(1):27-33.
Downing 1986 {published data only}
Ebenbichler 1999 {published data only}
  • Ebenbichler GR, Erdogmus CB, Resch KL, Funovics MA, Kainberger F, Barisani G, et al. [Ultrasound therapy for calcific tendinitis of the shoulder]. New England Journal of Medicine 1999;340:1533-8.
England 1989 {published data only}
Ginn 1997 {published data only}
Herrera-Lasso 1993 {published data only}
  • Herrera-Lasso I, Moborak L, Fernandez-Dominguez L, Cardiel M, Alarcon-Segovia D. [Comparative effectiveness of packages of treatment including ultrasound or transcutaneous electrical nerve stimulation in painful shoulder syndrome]. Physiotherapy 1993;79(4):251-253.
Leclaire 1991 {published data only}
  • Leclaire R, Bourgouin J. [Electromagnetic treatment of shoulder periarthritis: a randomised controlled trial of efficiency and tolerance of magnetotherapy]. Archives of Physical Medicine & Rehabilitation 1991;72:284-288.
Lee 1973 {published data only}
  • Lee M, Haq A, Wright V, Longton E. [Periarthritis of the shoulder: A controlled trial of physiotherapy]. Physiotherapy 1973;59(10):312-315.
Nicholson 1985 {published data only}
  • Nicholson G. [The effects of passive joint mobilisation on pain and hypomobility associated with adhesive capsulitis of the shoulder]. Journal of Orthopaedic & Sports Physical Therapy 1985;6:238-246.
Nykanen 1995 {published data only}
  • Nykanen M. [Pulsed ultrasound treatment of the painful shoulder: A randomized, double-blind, placebo-controlled study]. Scandinavian Journal of Rehabilotation Medicine 1995;27:105-108.
Perron 1997 {published data only}
  • Perron M, Malouin F. [Acetic acid iontophoresis and ultrasound for the treatment of calcifying tendinitis of the shoulder: A randomized control trial]. Archives of Physical Medicine and Rehabilitation 1997;78:379-384.
Reid 1996 {published data only}
  • Reid D, Saboe L, Chepeha J. [Anterior shoulder instability in athletes: comparison of isokinetic resistance exercises and an electromyographic biofeedback re-education program - a pilot program]. Physiotherapy Canada 1996;48(4):251-256.
Saunders 1995 {published data only}
  • Saunders L. [The efficacy of low level laser therapy in supraspinatus tendinitis]. Clinical Rehabilitation 1995;9:126-34.
Shehab 2000 {published data only}
  • Shehab D, Adham N. [Comparative effectiveness of ultrasound and transcutaneous electrical stimulation in treatment of periarticular shoulder pain]. Physiotherapy Canada 2000;52(3):208-210, 214.
Taverna 1990 {published data only}
  • Taverna E, Parrini M, Cabitza P. Laser therapy versus placebo in the treatment of some bone and joint pathology [Laserterapia IR versus placebo nel trattamento di alcune patologie a carcio dell'apparato locomotore]. Minerva Ortopedica E Traumatologica 1990;41:631-6.
van der Heijden 1999 {published data only}
  • van der Heijden GJMG, Leffers P, Wolters PJMC, Verheijden JJD, van Mameren HHJP, Bouter LM, Knipschild PG. [No effect of bipolar interferential electrotherapy and pulsed ultrasound for soft tissue shoulder disorders: a randomised controlled trial]. Annals of Rheumatic Diseases 1999;58(9):530-540.
  • van der Heijden GJMG, van der Windt DAWM. [Shoulder disorders in primary care: prognosis and management]. Dutch Journal of Physical Therapy 1999;May:19-22.
van der Windt 1998 {published data only}
  • van der Windt DAWM, Koes BW, Deville W, Boeke QAJP, de Jong BA, Bouter LM. [Effectiveness of corticosteroid injections versus physiotherapy for treatment of painful stiff shoulder in primary care: randomised trial]. British Medical Journal 1998;317(7168):1292-1296.
Vecchio 1993 {published data only}
  • Vecchio P, Cave C, King V, Adebajo AO, Smith M, Hazleman BL. [A double-blind study of the effectiveness of low level laser treatment of rotator cuff tendinitis]. British Journal of Rheumatology 1993;32(740-42).
Winters 1997/9 {published data only}
  • Winters JC, Jorritsma W, Groenier KH, Sobel JS, Meyboom-de-Jong B, Hans J. [Treatment of shoulder complaints in general practice: long term results of a randomised, single blind study comparing physiotherapy, manipulation, and corticosteroid injection]. British Medical Journal 1999;318(7195):1395-1396.
  • Winters JC, Sobel JS, Groenier KH, Arendzen HJ, Meyboom-de-jong, B. [Comparison of physiotherapy, manipulation, and corticosteroid injection for treating shoulder complaints in general practice: Randomized, single blind study]. British Medical Journal 1997;314:1320-1325.
  • Winters JC, Sobel JS, Groenier KH, et al. [Comparison of physiotherapy, manipulation and corticosteroid injection for treating shoulder complaints in general practice]. Journal of Family Practice (Journal Club) 1997;45(2):103-4.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Anderson 1996 {published data only}
  • Anderson NH, Johannsen HV. Sneppen O. [Self-training versus physiotherapist guided rehabilitation after arthroscopic deconmpression- a prospective randomized study]. Acta Orthopaedica Scandinavica 1996;Suppl 272:67.
Arciero 1994 {published data only}
  • Arciero RA, Wheeler JH, Ryan JB, McBride JT. [Arthroscopic bankart repair versus non operative treatment for acute initial anterior shoulder dislocations]. American Journal of Sports Medicine 1994;22(5):589-94.
Arslan 2001 {published data only}
  • Arslan S, Celiker R. [Comparison of the efficacy of local corticosteroid injection and physical therapy for the treatment of adhesive capsulitis]. Rheumatology International 2001;21(1):20-23.
Biswas 1979 {published data only}
  • Biswas AK, Sur BN, Gupta CR. [Treatment of periarthritis shoulder]. Journal of the Indian Medical Association 1979;72:276-7.
Chee 1986 {published data only}
  • Chee E, Walton H. [Treatment of Trigger Points with Microamperage Transcutaneous Nerve Stimulation (TENS) - (The Electro-Acuscope 80)]. Journal of Manipulative & Physiological Therapeutics 1986;9(2):131-134.
Curtis 1999 {published data only}
Echternach 1966 {published data only}
  • Echternach J. [Audioanalgesia as an adjunct to mobilization of the chronic frozen shoulder]. Physical Therapy 1966;46(8):839-46.
Gam 1998 {published data only}
Grossi 1986 {published data only}
  • Grossi E, Monza GC, Pollavini S, Bona L. [NSAID ionisation in the management of soft-tissue rheumatism: Role played by the drug, electrical stimulation and suggestion]. Clinical and Experimental Rheumatology 1986;4:265-267.
Hagberg 2000 {published data only}
  • Hagberg M, Harms-Ringdahl K, Nisell R, Hjelm E. [Rehabilitation of neck-shoulder pain in women industrial workers: a randomised trial comparing isometric shoulder endurance training with shoulder strength training]. Archives of Physical Medicine & Rehabilitation 2000;81(8):1051-1058.
Inaba 1972 {published data only}
  • Inaba MK, Piorkowski M. [Ultrasound treatment of painful shoulders in patients with hemiplegia]. Physical Therapy 1972;52:737-41.
Lastayo 1998 {published data only}
  • Lastayo P, Wright T, Jaffe R, Hartzel J. [Continuous passive motion after repair of the rotator cuff: A prospective outcome study]. Journal of Bone & Joint Surgery - American Volume 1998;80(7):1002-1011.
Leandri 1990 {published data only}
Leboeuf 1987 {published data only}
  • Leboeuf C, Grant B, Maginnes GS. [Chiropractic treatment of repetitive strain injuries: A preliminary prospective outcome study of SMT versus SMT combined with massage]. Journal of Australian Chiropractors' Association 1987;17:11-14.
Livesley 1992 {published data only}
Lloyd-Roberts 1959 {published data only}
Lundberg 1979 {published data only}
  • Lundberg BJ, Svenungsos-Hartwig E, Wikmark R. [Independent exercises versus physiotherapy in non-displaced proximal humeral head fractures]. Scandinavian Journal of Rehabilitation Medicine 1979;11:133-136.
Lundblad 1999 {published data only}
  • Lundblad I, Elert J, Gerdle B. [Randomized controlled trial of physiotherapy and feldenkrais interventions in female workers with neck-shoulder complaints]. Journal of Occupational Rehabilitation 1999;9(3):179-193.
Melzer 1995 {published data only}
Meyer 1997 {published data only}
  • Meyer M, Liebau C, Merk H. [Therapy for idiopathic frozen shoulder stages 2 and 3 - Manipulation under anaesthesia versus arthroscopy: A prospective study]. The Journal of Bone and Joint Surgery - British Volume (1997).;79B(supp. 2):202.
Morgan 1995 {published data only}
  • Morgan B, Jones A, Mulcahy K, Finlay D, Collett B. [Transcutaneous electric nerve stimulation (TENS) during distension shoulder arthrography: a controlled trial]. Pain 1995;64:265-267.
Nash 1990 {published data only}
  • Nash TP, Williams JD, Machin D. [TENS: Does the type of stimulus really matter?]. Pain Clinic 1990;3:161-168.
Partridge 1990 {published data only}
  • Partridge CJ, Edwards SM, Mee R, Langenberghe HVK van. [Hemiplegic shoulder pain: a study of two methods of physiotherapy treatment]. Clinical Rehabilitation 1990;4:43-9.
Philipson 1983 {published data only}
  • Philipson T, Haagensen N, Laumann V, Nies M, Thorup K, Hansen TI. [The effect of diadynamic current on chronic soft tissue pain in the neck and shoulder girdle]. Ugeskr Laeger 1983;145(7):479-481.
Quin 1965 {published data only}
  • Quin CE. [Frozen shoulder: Evaluation of tretment with hydrocortisone injections and exercises]. Annals of Physical Medicine 1965;8:22-29.
Raab 1996 {published data only}
  • Raab M, Rzeszutko D, O'Connor W, Greatting M. [Early results of continuous passive motion after rotator cuff repair: a prospective, randomised, blinded, controlled study]. American Journal of Orthopaedics 1996;25(3):214-220.
Rahme 1998 {published data only}
  • Rahme H, Solem-Bertoft E, Westerberg CE, Lundberg E, Sorensen S, Hilding S. [The subacromial impingement syndrome. A study of results of treatment with special emphasis on predictive factors and pain-generating mechanisms]. Scandinavian Journal of Rehabilitative Medicine 1998;30(4):253-62.
Randlov 1998 {published data only}
  • Randlov A, Ostergaard M, Manniche C, Kryger P, et al. [Intensive dynamic training for females with chronic neck/ shoulder pain. A randomised controlled trial]. Clinical Rehabilitation 1998;12:200-210.
Ritchie 1997 {published data only}
  • Ritchie, ED, Tong, D, Chung, F, Norris, A, Miniaci, A, & Vairavanathan, S. D. [Suprascapular nerve block - A new technique for pain relief in arthroscopic shoulder surgery?]. The Journal of Bone and Joint Surgery - British Volume 1997;79B(supp. 1):72-73.
Rizk 1983 {published data only}
  • Rizk T, Christopher R, Pinals R. [Adhesive Capsulitis (Frozen Shoulder): A new approach to its management]. Archives of Physical Medicine & Rehabilitation 1983;64:29-33.
Speer 1996 {published data only}
  • Speer K, Warren R, Horowitz. [The efficacy of cryotherapy in post-operative shoulder]. Journal of Shoulder & Elbow Surgery 1996;5:62-8.
Spence 1995 {published data only}
  • Spence SH, Sharpe L, Newton-John T, Champion D. [Effect of EMG biofeedback compared to applied relaxation training with chronic, upper extremity cumulative trauma disorders]. Pain 1995;63:199-206.
Vasseljen 1998 {published data only}
  • Vasseljen O, Johansen B, Westgaard R. [The effect of pain reduction on perceived tension and EMG recorded trapezius muscle activity in workers with shoulder and neck pain]. Scandinavian Journal of Rehabilitation Medicine 1995;27:243-252.
Vecchini 1984 {published data only}
  • Vecchini L, Grossi E. [Ionisation with diclofenac sodium in rheumatic disorders: A double blind placebo controlled trial]. Journal of International Medical Research 1984;12:346-350.
Waldburger 1992 {published data only}
Waling 2000 {published data only}
  • Waling K, Sundelin G, Ahlgren C, Jarvholm B. [Perceived pain before and after three exercise program - a controlled clinical trial of women with work related trapezius myalgia]. Pain 2000;85(1-2):201-207.
Williams 1986 {published data only}
  • Williams J, Harvey J, Tannenbaum H. [Use of superficial heat versus ice for rheumatoid arthritic shoulder. A pilot study]. Physiotherapy Canada 1986;38:8-13.
Wolf 1996 {published data only}
  • Wolf M, Gomez R. [Independent home therapy versus formal physical therapy following arthroscopic shoulder surgery]. American Academy of Orthopaedic Surgeons: Scientific Program. Abstract in Orthopaedic Transactions 1996;20:20.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Chard 1988 {published data only}
  • Chard MD, Hazleman BL, Devereaux MD. Controlled trial to investigate dose-response patterns to portable, pulsed electromagnetic fields in the treatment of rotator cuff tendinitis: a review trial. J Orthop Rheumatol 1988;1:33-40.
Gudmundsen 1987 {published data only}
  • Gudmundsen J, Vikne J. Laser treatment for epicondylitis humeri and rotator cuff syndrome. Nord Tidsskr Idrettsmed 1987;2:6-15.
Knorre 1990 {published data only}
  • Knorre, von B, Keitel, W. [Vergleichende Therapiestudie: Ultraschall, Kryotherapie und intraartikulare Kortisonoide bei Veranderungen des Schultergelenkes aus entzundlicher Ursache]. Z. Physiother. Jg. 1990;42:221-225.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Allander 1974
Badley 1992
  • Badley EM, Tennant A. [Changing profile of joint disorders with age: Findings from a postal survey of the population of Calderdale, West Yorkshire, United Kingdom]. Annals of Rheumatic Diseases 1992;51(3):366-371.
Beaton 1996
  • Beaton D, Richards L. [Measuring Function of the Shoulder]. The Journal of Bone and Joint Surgery 1996;78-A:882-90.
Bjelle 1989
Bridges Webb 1992
  • Bridges-Webb CH, Britt D, Miles S, Neary A, Charles M. [Treatment in general practice in Australia]. Medical Journal of Australia 1992;Suppl(S1-S56).
Chakravarty 1993
Chard 1991
  • Chard MD, Hazleman R, Hazleman BL, King RH, Reiss BB. [Shoulder disorders in the elderly: a community survey]. Arthritis & Rheumatism 1991;34(6):766-769.
    Direct Link:
Gartsman 1998
  • Gartsman GM, Brinker MR, Khan M, Karahan M. [Self assessment of general health status in patients with five common shoulder conditions]. Journal of Shoulder and Elbow Surgery 1998;7(3):228-237.
Goupille, 1996
  • Goupille P, Sibillia J. [Local corticosteroid injections in the treatment of rotator cuff tendinitis (except for frozen shoulder and calcific tendinitis)]. Clinical & Experimental Rheumatology 1996;14(5):561-6.
Green 1999
  • Green S, Buchbinder R, Glazier R, Forbes A. The Cochrane Library 1999, Issue 1.
Hill 1983
  • Hill JA. [Epidemiologic Perspective on Shoulder Injuries]. Clinics in Sports Medicine 1983;2(2):241-246.
Ingemar 1993
  • Ingemar-Andersson H, Ejlertsson G, Leden I, Rosenberg C. [Chronic Pain In a Geographically Defined General Population: Studies of Differences in age, gender, social class, and pain localization]. Clinical Journal of Pain 1993;9(3):174-182.
Juni 1999
Lundberg 1969
  • Lundberg B. [The frozen shoulder]. Acta Orthopaedica Scandinavia 1969;Suppl 119.
Pope 1997
Rekola 1993
  • Rekola KE, Keinanen-Kiukaanniemi S, Takala J. [Use of primary health services in sparsley populated country districts by patients with musculoskeletal symptoms: consultations with a physician]. Journal of Epidemiology & Commumity Health 1993;47(2):153-157.
v der Heijden 1997
  • Van Der Heijden GJMG, Van der Windt DAWM, De Winter SF. [Physiotherapy for patients with soft tissue shoulder disorders: a systematic review of randomised clinical trials]. British Medical Journal 1997;315(7099):25-30.
van der Heijden 1996
  • Van Der Heijden GJMG, Van Der Windt DAWM, Kleijnen J, Koes B, Bouter L. [Steroid injections for shoulder disorders: a systematic review of randomised clinical trials]. British Journal of General Practice 1996;46:309-316.
van der Windt 1995
  • Van Der Windt DAWN, Van Der Heijden GJMG, Scholten RJPM, Koes BW, Bouter LM. [The efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) for shoulder complaints: A systematic review]. Journal of Clinical Epidemiology 1995;48(5):691-704.

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Green 1998
  • Green S, Buchbinder R, Glazier R, Forbes A. [Systematic review of randomised controlled trials of interventions for painful shoulder: selection criteria, outcome assessment and efficacy]. British Medical Journal 1998;316:354-360.
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