Editor's Note: Part 1 of this article (July digital issue) discussed the ineffectiveness of nerve blocks and surgery, and the research support for spinal manipulation, kinesiology tape and laser therapy.
Massage Therapy
Many practitioners use massage therapy as an adjunct therapy for shoulder pain, and for good reason. In 2003, Van den Dolder, et al., designed a single-blinded randomized, controlled trial of 29 patients. This study revealed that patients with shoulder pain may benefit from soft-tissue massage in terms of reducing pain, increasing range of motion and improving performance.10
In 2017, Yeun, et al., performed a systematic review and meta-analysis of 15 studies involving more than 600 participants. Massage therapy is an effective treatment for shoulder pain, according to this study.11
Acupuncture
Acupuncture has promising research in for adhesive capsulitis specifically. In 2017, Schroder, et al., designed a double-blinded, placebo-controlled, randomized, controlled trial involving 60 subjects. An examination of the results of this study revealed that acupuncture combined with conservative therapy were more effective in recovering from adhesive capsulitis as compared to conservative therapy alone.12
Recently, in 2020, Ben-Arie, et al., conducted a systematic review and meta-analysis of 13 publications. According to this study, acupuncture may be an effective, safe, and quick means to reduce shoulder pain, restore shoulder function, and also restore shoulder range of motion for patients suffering from adhesive capsulitis in the short- to mid-term.13
Nutrition: Omega-3s
Omega 3 fatty acids have emerging research supporting their use in the treatment of shoulder pain caused by rotator-cuff tendinopathy. In 2008, Lewis, et al., conducted a literature review of scientific databases. There is some evidence to support the use of omega-3 supplementation as a treatment for tendinopathy based on the findings of the review.14
In 2018, Sandford, et al., conducted a double-blind, placebo-controlled, randomized, controlled trial involving 73 participants. A modest effect of omega-3 supplementation on disability and pain outcomes was noted for patients with rotator cuff-related shoulder pain.15
Clinical Takeaway
Research suggests that in addition to spinal manipulation, nonpharmacological modalities including kinesiology tape, low-level laser therapy, massage therapy, acupuncture and omega-3 supplementation can be utilized effectively in the treatment of shoulder pain as alternatives to nerve blocks and surgery.
References
10. van den Dolder PA, Roberts DL. A trial into the effectiveness of soft tissue massage in the treatment of shoulder pain. Aust J Physiother, 2003;49(3):183-188.
11. Yeun Y-R. Effectiveness of massage therapy for shoulder pain: a systematic review and meta-analysis. J Phys Ther Sci, 2017;29(5):936-940
12. Schröder S, Meyer-Hamme G, et al. Immediate pain relief in adhesive capsulitis by acupuncture-a randomized controlled double-blinded study. Pain Med, 2017;18(11):2235-2247.
13. Ben-Arie E, Kao P-Y, Lee Y-C, et al. The effectiveness of acupuncture in the treatment of frozen shoulder: a systematic review and meta-analysis. Evid-Based Compl Alt Med, 2020;2020:1-14.
14. Lewis JS, Sandford FM. Rotator cuff tendinopathy: is there a role for polyunsaturated Fatty acids and antioxidants? J Hand Ther,2009;22(1):49-55; quiz 56.
15. Sandford FM, Sanders TA, Wilson H, Lewis JS. A randomised controlled trial of long-chain omega-3 polyunsaturated fatty acids in the management of rotator cuff related shoulder pain. BMJ Open Sport Exerc Med, 2018;4(1):e000414.
