Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis

Abstract

ObjectiveTo determine the effectiveness of exercise and soft tissue massage either in isolation or in combination for the treatment of non-specific shoulder problems.MethodsDatabase searches for articles from 1966 to December 2011 were performed. Studies were eligible if they investigated ‘hands on’ soft tissue massage performed locally to the shoulder or exercises aimed at improving strength, range of motion or coordination; non-surgical painful shoulder disorders; included participants aged 18–80 years and outcomes measured included pain, disability, range of motion, quality of life, work status, global perceived effect, adverse events or recurrence.ResultsTwenty-three papers met the selection criteria representing 20 individual trials. We found low-quality evidence that soft tissue massage was effective for producing moderate improvements in active flexion and abduction range of motion, pain and functional scores compared with no treatment, immediately after the cessation of treatment. Exercise was shown by meta-analysis to produce greater improvements than placebo, minimal or no treatment in reported pain (weighted mean=9.8 of 100, 95% CI 0.6 to 19.0) but these changes were of a magnitude that was less than that considered clinically worthwhile. Exercise did not produce greater improvements in shoulder function than placebo, minimal or no treatment (weighted mean=5.7 of 100, 95% CI −3.3 to 14.7).ConclusionThere is low-quality evidence that soft tissue massage is effective for improving pain, function and range of motion in patients with shoulder pain in the short term. Exercise therapy is effective for producing small improvements in pain but not in function or range of motion.

The presentation and outcomes of shoulder pain in public hospital physiotherapy departments in NSW: an observational study

“…There is some evidence that massage produces gains in flexion and HBB range (van den Dolder, Ferreira, and Refshauge, 2012;van den Dolder and Roberts, 2003), Exercise has been demonstrated to significantly improve range for flexion and abduction in patients with shoulder pain (Ginn and Cohen, 2005;Ginn, Herbert, Khouw, and Lee, 1997), However, a recent systematic review noted that exercise does not improve range of motion (van den Dolder, Ferreira, and Refshauge, 2012), Our findings further add to this debate and support the need for further investigation as to the effect of various treatments on shoulder range.…”

“…van der Windt, Koes, De Jong, and Bouter (1995) noted that physiotherapy was the preferred management option used by general practitioners for patients with rotator cuff tendinitis. There is a growing volume of research into the management of shoulder complaints with some specific physiotherapy interventions shown to be effective (Ginn and Cohen, 2005;Ginn, Herbert, Khouw, and Lee, 1997;Green, Buchbinder, and Hetrick, 2003;Kuhn, 2009;van den Dolder, Ferreira, and Refshauge, 2012;van den Dolder and Roberts, 2003). However, physiotherapy management of shoulder pain often involves combination therapy, which has only undergone limited investigation to date (Green, Buchbinder, and Hetrick, 2003).…”

Energy expenditure for massage therapists during performing selected classical massage techniques

“…It is also used in sports as a form of action to accelerate post-exercise recovery and to prepare an athlete for increased training workloads. It is also applied in the broadly understood biological renewal -relieving effects of long-term stress or in cosmetics -as part of care treatments [1][2][3][4][5]. The traditional division of massages is: therapeutic massage, sports massage, hygienic-cosmetic massage [6].…”

“…The tissue response is the effect of reflex action via mechanoreceptors and chemoreceptors. These reactions may result in changes in distal tissues and organs translating into the effects of the general massage and improving the emotional state of patients [1][2][3][4][5]8]. Achieving the desired results requires a masseur to perform physical labor, based on dynamic efforts mainly involving the upper limbs, executed in a forced static standing position with the body leaning forward.…”

Influence of psychological factors on the prognosis of chronic shoulder pain: protocol for a prospective cohort study

“…18 Despite the large group of individuals seeking for primary-care services, about 50% of patients with shoulder pain still report persistent pain after 12 months. 9 16 18 19 As a result, socioeconomic burdens are considerable due to extensive use of heath care services, sickness absence, disability pension and loss of productivity, [20][21][22][23][24] as well as patient's suffering.…”