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Shoulder pain interventions: from the Cochrane Library

One of the most important functions of the Cochrane Library is to demonstrate what we do not know. Good quality reviews that find no trials, no good trials, or good trials with no effect, are really important in delimiting the extent of our knowledge (or ignorance). This survey briefly examines a number of negative reviews on shoulder pain.


Acupuncture


S Green et al. Acupuncture for shoulder pain. Cochrane Database of Systematic Reviews 2005 issue 2.


Clinical bottom line

There were nine trials, including those of low quality. No benefit from acupuncture was demonstrated.


Physiotherapy


S Green et al. Physiotherapy interventions for shoulder pain. Cochrane Database of Systematic Reviews 2003 issue 2.


Clinical bottom line

There were 26 trials, including those of low quality, and looking at a whole range of different interventions or groups of interventions, including ultrasound and laser therapy. No benefit from physiotherapy was evident, but physiotherapy may be less good than steroid injections.


Corticosteroid injections


R Buchbinder et al. Corticosteroid injections for shoulder pain. Cochrane Database of Systematic Reviews 2003 issue 1.


Clinical bottom line

There were 26 trials, including those of low quality. No benefit from corticosteroid injections was evident.


Electrical stimulation for post-stroke shoulder pain


C Price, A Pandyan et al. Electrical stimulation for preventing and treating post-stroke shoulder pain. Cochrane Database of Systematic Reviews 2000 issue 4.


Clinical bottom line

There were four trials with 170 patients. No benefit was evident.