Effectiveness of Low-Level Laser Therapy Combined With an Exercise Program to Reduce Pain and Increase Function in Adults With Shoulder Pain: A Critically Appraised Topic

Abstract

Shoulder pain is a common musculoskeletal condition that affects up to 25% of the general population. 1 Shoulder pain can be caused by any number of underlying conditions including subacromial impingement syndrome, rotator-cuff tendinitis, and biceps tendinitis. 2,3 Regardless of the specific pathology, pain is generally the number 1 symptom associated with shoulder injuries and can severely affect daily activities 4 and quality of life 5,6 of patients with these conditions. Two of the primary goals in the treatment of these conditions is reducing pain and increasing shoulder range of motion (ROM). 3 Conservative treatment has traditionally included a therapeutic exercise program targeted at increasing ROM, strengthening the muscles around the joint, proprioceptive training, or some combination of those activities. 7,8 In addition, these exercise programs have been supplemented with other interventions including nonsteroidal anti-inflammatory drugs, corticosteroid injections, manual therapy, activity modification, and a wide array of therapeutic modalities (eg, cryotherapy, EMS, ultrasound). 2,3,7 Recently, low-level laser therapy (LLLT) has been used as an additional modality in the conservative management of patients with shoulder pain. 3,9,10 However, the true effectiveness of LLLT in decreasing pain and increasing function in patients with shoulder pain is unclear. Focused Clinical QuestionIs low-level laser therapy combined with an exercise program more effective than an exercise program alone in the treatment of adults with shoulder pain?Summary of Search, "Best Evidence" Appraised, and Key Findings• The literature was searched for studies of level 2 evidence or higher that investigated the effects of LLLT on pain and function in adults with shoulder pain.• The literature search returned 7 possible studies related to the clinical question; 4 randomized controlled trials met the inclusion criteria and were included. Aimee L. Thornton, Cailee W. McCarty, and Mollie-Jean BurgessClinical Scenario: Shoulder pain is a common musculoskeletal condition that affects up to 25% of the general population. Shoulder pain can be caused by any number of underlying conditions including subacromial impingement syndrome, rotator-cuff tendinitis, and biceps tendinitis. Regardless of the specific pathology, pain is generally the number 1 symptom associated with shoulder injuries and can severely affect daily activities and quality of life of patients with these conditions. Two of the primary goals in the treatment of these conditions are reducing pain and increasing shoulder range of motion (ROM). 3 Conservative treatment has traditionally included a therapeutic exercise program targeted at increasing ROM, strengthening the muscles around the joint, proprioceptive training, or some combination of those activities. In addition, these exercise programs have been supplemented with other interventions including nonsteroidal anti-inflammatory drugs, corticosteroid injections, manual therapy, activity modification, and a wide array ...

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