Effectiveness of conservative therapy in tendinopathy-related shoulder pain: A systematic review of randomized controlled trials.

Abstract

OBJECTIVE\nSystematic review investigated efficacy of conservative therapy on pain and function in people with tendinopathy-related shoulder pain.\n\n\nMETHODS\nSearches were conducted on six databases. All randomized controlled trials investigating efficacy of any conservative therapy on pain and function in people with tendinopathy-related shoulder pain were included. Estimates for each specific conservative therapy were presented as weighted mean differences (WMDs) or mean differences (MDs), with 95% confidence intervals (CIs). Quality of the evidence was assessed using GRADE.\n\n\nRESULTS\nFive randomized controlled trials were included. Extracorporeal shock-wave therapy (ESWT) was effective on pain at short-term (i.e., ≤3 months) when compared with control (WMD\xa0=\xa0-1.7 out of 101 points,\xa0-3.1 to\xa0-0.3; n\xa0=\xa0158). Individual trials also suggested effects of non-steroidal anti-inflammatory drugs (NSAIDs) (-13.7 to\xa0-2.3; n\xa0=\xa0365) and extracorporeal radial pressure pulse therapy (rESWT) (-40.0 to\xa0-27.0; n\xa0=\xa079). Laser therapy and ESWT were not effective on pain and function at short-term, respectively. No trials investigated medium- or long-term effects, and quality of the evidence ranged from low to very low quality.\n\n\nCONCLUSIONS\nConservative therapies currently available for the rotator cuff management and biceps tendinopathy are not supported by low to very-low quality evidence.