Strategies for Shoulder Impingement and Tendon Pathology
#5 Control pain and inflammation Any number of modalities could be used to help in this area. A recent meta analysis of 177 trials that reviewed twenty treatment options for addressing subacromial dysfunction concluded that six modalities/ treatments had a high probability of being most effective, in the short term, for pain and function. These included: 42
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Acupuncture
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Exercise plus manual therapy
Manual therapy
PBMT (laser therapy)
Exercise
Microcurrent (MENS) (TENS) 42
Intelect® RPW2
High power laser and radial shockwave technologies both have the ability to change pain quickly and restore ROM, albeit via different mechanisms. 28,43 These devices should help restore ROM and reduce pain more effectively than exercise alone. A meta-analysis by Steuri et al. concluded that shoulder exercises should be part of the treatment program but that adding laser or shockwave therapy can provide an additional benefit to patients. 64
Yilmaz et al. recommends a multimodal approach to control pain that can include treatments like TENS and superficial hot and cold applications. 44
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