Abstract
The current systematic review aimed to compare the effect of injury-focused (specific) exercises versus more general (non-specific) exercises on pain in patients with chronic neck or shoulder pain. We searched PubMed, EMBASE, and Web of Science. Two reviewers screened and selected studies, extracted outcomes, assessed risk of bias, and rated the quality of evidence. A total of nine eligible studies, represented in 13 articles, were identified, with a considerable risk of bias. One article investigated the acute effect of single bouts of exercise on pain and reported an immediate pain reduction after non-specific exercise. Regarding short-term effects, seven out of the nine studies found no differences in pain between interventions, with inconsistent results among two other studies. Concerning the long-term effects, while pain reduction seems to be favored by specific exercises (two out of four articles), the best format is still unclear. Based on the acute effects, a single bout of non-specific exercise seems to be a better option for pain-relief for patients with chronic neck or shoulder pain. For short-term effects, there are no differences in pain between specific and non-specific exercises. Regarding long-term effects, specific exercises seem to be the best option. Nevertheless, more studies are warranted.
Highlights
IntroductionShoulder pain is responsible for approximately 16% of all musculoskeletal complaints [4], with a yearly incidence of 15 new episodes per 1.000 patients seen in primary care settings [5]
After manual searching of the reference lists, two more eligible articles were identified for inclusion
The aim of this review was to evaluate the effect of SE, involving exercises focused on the neck and/or shoulder region, focused on chronic neck or shoulder pain (CNSP) patients, looking for pain reduction/increases compared to NSE
Summary
Shoulder pain is responsible for approximately 16% of all musculoskeletal complaints [4], with a yearly incidence of 15 new episodes per 1.000 patients seen in primary care settings [5]. To 50% of patients reporting persistent symptoms after 6 to 12 months [6] and 14% of patients continuing care after 2 years [7]. Treating patients with chronic neck or shoulder pain (CNSP) is a challenging issue for clinicians. Exercise therapy is found to be an effective treatment strategy to relieve pain and improve patient’s level of functioning in daily activities in various chronic musculoskeletal pain disorders, including chronic neck pain [8,9,10,11] and chronic shoulder pain [12,13]. The evidence for exercise therapy is strong, it is still difficult to demonstrate the superiority of one exercise approach over another in chronic pain populations [14]
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