The effectiveness of education for people with shoulder pain: A systematic review

Abstract

OBJECTIVES: To investigate the effectiveness of education for people with shoulder pain. DESIGN: Systematic review LITERATURE SEARCH: We searched several databases (e.g. MEDLINE, EMBASE, CENTRAL, CINAHL) and trial registries from inception to May 25, 2023. STUDY SELECTION CRITERIA: Randomised controlled trials investigating any education for people with shoulder pain. DATA SYNTHESIS: Pain and disability were primary outcomes. The Physiotherapy Evidence Database (PEDro) scale was used to assess methodological quality. Meta-analysis was not appropriate due to heterogeneity. RESULTS: We included 14 trials (8 had high methodological quality). The one trial on rotator-cuff related shoulder pain did not assess pain or disability but found best practice education (vs. structure-focused education) increased reassurance and intentions to stay active. The one trial on adhesive capsulitis found daily reminders, encouragement, and education about exercise via text did not improve pain and disability compared to no education. For post-operative shoulder pain, two (of four) trials found education reduced some measure of pain, but none found an effect on disability or any other outcomes. For 'shoulder complaints' (i.e. mixed or unclear diagnosis), no trials found education was more effective than home exercise or no education for improving pain or disability. CONLUSION: Some forms of education appear to improve reassurance, treatment intentions, perceived treatment needs, recovery expectations, and knowledge, but their effect on pain and disability is unclear. High-quality trials are needed to resolve uncertainty surrounding the benefit of education for shoulder pain, particularly rotator-cuff related shoulder pain and adhesive capsulitis.