Electrotherapy modalities for adhesive capsulitis (frozen shoulder)

Abstract

Based upon low quality evidence from one trial, LLLT for six days may be more effective than placebo in terms of global treatment success at six days. Based upon moderate quality evidence from one trial, LLLT plus exercise for eight weeks may be more effective than exercise alone in terms of pain up to four weeks, and function up to four months. It is unclear whether PEMF is more or less effective than placebo, or whether other electrotherapy modalities are an effective adjunct to exercise. Further high quality randomised controlled trials are needed to establish the benefits and harms of physical therapy interventions (that comprise electrotherapy modalities, manual therapy and exercise, and are reflective of clinical practice) compared to interventions with evidence of benefit (for example glucocorticoid injection or arthrographic joint distension).

Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions

“…Three studies 5,6,21 were scored as high quality, and 3 were scored as acceptable quality. [39][40][41] Two of the high-quality studies were conducted by the same research team.…”

“…[39][40][41] Two of the high-quality studies were conducted by the same research team. 5,6 The first meta-analysis reviewed the evidence of electrotherapy modalities, delivered alone or in combination with other interventions, for the treatment of AC. 5 Nineteen trials (RCTs and controlled clinical trials, 1249 participants) were included in the review.…”

“…5,6 The first meta-analysis reviewed the evidence of electrotherapy modalities, delivered alone or in combination with other interventions, for the treatment of AC. 5 Nineteen trials (RCTs and controlled clinical trials, 1249 participants) were included in the review. Two electrotherapy modalities studies compared low-level laser therapy (LLLT) and pulsed electromagnetic field therapy (PEMF) with placebo.…”

“…There was moderate-quality evidence that LLLT plus exercise for 8 weeks may improve pain for up to 4 weeks and function for up to 4 months longer than placebo plus exercise. 5 The overall conclusion of this SR is that only 1 electrotherapy modality, LLLT, has evidence of benefit when compared when placebo or when used as an adjunct to exercise.…”

“…4 Other conditions include those that are unspecified and adhesive capsulitis (AC). 5,6 Primary treatment options considered in usual care typically consist of analgesics or exercises and progress to secondary and tertiary options of steroid injections or surgery if necessary. 7,8 Compared with more conservative treatments, surgery is likely more costly and risky.…”