Aspecifieke schouderklachten: geen effectiviteit van de gangbare behandelingen; literatuurstudie

To assess the efficacy of current interventions for shoulder complaints in adults.

Design

Systematic literature review.

Method

Medline and the Cochrane Library were searched for systematic reviews and randomised studies on the efficacy of interventions for shoulder complaints in adults. Studies of patients with an identifiable cause of shoulder symptoms or an underlying disease were excluded. Studies evaluating pain, function and duration of symptoms were included.

Results

Of the 111 randomised clinical trials found, only a few (19) focused on aspecific shoulder complaints; the remainder involved poorly defined subgroups. 11 useful studies were identified. There was little or no evidence to support or refute the efficacy of NSAIDs, exercise therapy, manipulative therapy, corticosteroid injection and acupuncture in comparison to placebo for the treatment of shoulder complaints. Moderate evidence was found to support the efficacy of NSAIDs, exercise therapy, manipulative therapy, corticosteroid injection and acupuncture in head-to-head comparisons with one another. These effects were not clinically relevant. The effect of adjuvant ultrasound therapy was comparable to that of placebo.

Conclusion

The available evidence indicates that the efficacy of interventions commonly used in the Netherlands for shoulder complaints is low, and the positive evidence available suggests a clinically irrelevant effect.

Ned Tijdschr Geneeskd. 2007;151:2892-7