Interventions to treat shoulder pain

BMJ 1998;316:1676 ( 30 May )

Letters

Interventions to treat shoulder pain

Review was overly negative

Lack of concordance between rheumatologists may render multicentre studies invalid

Authors' reply

Review was overly negative

The first 150 words of the full text of this article appear below.

EDITOR $---$ The systematic review by Green and colleagues of interventions for treating shoulder pain concluded that there is littleevidence to support the use of any of the common interventionsfor the management of shoulder pain.¹ This is a negative messagethat is likely to inhibit practitioners from treating patientswith shoulder pain and to dissuade them from referring these patientsto specialists. While we agree with the other conclusions of thestudy, we disagree with the negative message about treatment forseveral reasons.

Rheumatologists make decisions about the treatment of musculoskeletal disorders such as shoulder pain based on the durationof the condition, its severity, and a careful examination to definethe exact site of the lesion.² It is generally taught, forexample, that the injection of corticosteroids will only workif done soon after the onset of any shoulder disorder and if theinjection has been precisely . . . [Full text of this article]

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Systematic review of randomised controlled trials of interventions for painful shoulder: selection criteria, outcome assessment, and efficacy: Sally Green, Rachelle Buchbinder, Richard Glazier, and Andrew Forbes
BMJ 1998 316: 354-360. [Abstract] [Full Text] [PDF]