Does A Painful Shoulder Require Surgery?
A systematic review by Kuhn (2009), found that exercise has statistically and clinically significant effects on pain reduction and improving function. When combined with manual therapy this improvement was further strengthened.
Most studies in the review found that function improved with exercise. Interestingly when surgery was preformed and exercises were continued, there was no significant difference when compared with exercise alone.
It was identified that home exercise programs may be as effective as supervised exercise.
On reviewing the literature, it was suggested that patients should receive supervised therapy 2 -3 times per week. ROM and flexibility exercises should be completed daily and strengthening exercises 3 times per week.
In some cases ultrasound was found to be of no benefit in the treatment of shoulder pain due to rotator cuff impingement.
Research also showed that Physiotherapists were well qualified to treat a painful shoulder, and can also accurately diagnose the reason for this shoulder pain.
Kuhn JE. Exercise in the treatment of rotator cuff impingement: A systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg 2009; 18, 139 – 160
Michener LA, Walsworth MK, Doukas WC, Murphy KP. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabilitation; 90, Nov 2009, 1898 - 1903.