"Massage/Tuina for Periarthritis of Shoulder: A Systematic Review and Meta-Analysis"

Abstract

Background: Arthritis around the shoulder is more likely to occur in people around the age of 50, so it is commonly known as "fifty shoulders" or "frozen shoulders". The main symptom of shoulder periarthritis is pain around the shoulder joint, sometimes radiating to the upper arm. The pain is obvious at night, and the movement of the shoulder joint is limited, leading to contracture and adhesion of limited movement. Traditional Chinese medicine believes that physical weakness may be a factor in the occurrence of shoulder periarthritis, and many patients use massage (MS) to alleviate the symptoms of shoulder periarthritis.Objective: To evaluate the effectiveness of MS in the treatment of shoulder periarthritis. Methods:We searched 10 English and Chinese databases for randomized controlled trials (RCTs) of MS in the treatment of shoulder periarthritis. The PEDro scale was used to evaluate the methodological quality of randomized controlled trials. A meta-analysis of MS for shoulder periarthritis was Performed. Results:The meta-analysis included fourteen high-quality studies. The results showed superior effects of MS on pain reduction (N=760; SMD, 1.21; 95% CI, 0.88 to -1.54; P<0.00001, and shoulder Internal rotation (N=532; SMD, 8.11; 95% CI, 2.14 to -14.08; P=0.008. But the meta-analyses did not show significant immediate effects of MS on shoulder abduction (N=171; SMD, -0.78; 95% CI, −2.23 to 0.68; P=0.30) and shoulder flexion (N=279; SMD, 0.34; 95% CI, −0.14 to 0.81; P=0.16. Conclusion:MS may be effective in relieving shoulder pain and improving internal rotation in patients with periarthritis of shoulder, but it may not improve shoulder abduction and flexion. More high-quality and longer-term research is needed to prove the reliability of the evidence.