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    Most common causes of MSK shoulder pain and best evidence-based treatment for them:

    Here’s an overview of the most common causes of shoulder pain seen by chiropractors, physiotherapists, and musculoskeletal practitioners, along with evidence-based treatments for each condition.

    1. Rotator Cuff Tear

    A rotator cuff tear involves damage to the group of muscles and tendons that stabilize the shoulder, commonly resulting from acute injury or chronic degeneration.

    Evidence-Based Treatment:

    • Manual Therapy: Techniques such as joint mobilization and soft tissue release can help alleviate pain and improve shoulder range of motion (Huisstede et al., 2011).
    • Therapeutic Exercises: A structured rehabilitation program focusing on rotator cuff strengthening and range of motion exercises has been shown to enhance recovery (Kumar et al., 2015).
    • Education: Patients should be educated on activity modifications to avoid aggravating the shoulder (Kumar et al., 2015).

    2. Shoulder Impingement Syndrome

    Shoulder impingement syndrome occurs when the shoulder blade puts pressure on the rotator cuff tendons during arm elevation, leading to pain and reduced mobility.

    Evidence-Based Treatment:

    • Manual Therapy: Joint mobilization and soft tissue techniques can reduce pain and improve function (Huisstede et al., 2011).
    • Therapeutic Exercises: A rehabilitation program focused on shoulder blade stability and rotator cuff strengthening is effective in managing symptoms (Kumar et al., 2015).
    • Education: Patients should learn about proper mechanics during overhead activities to minimize symptoms (Kumar et al., 2015).

    3. Frozen Shoulder (Adhesive Capsulitis)

    Frozen shoulder is characterized by stiffness and pain in the shoulder joint due to inflammation and thickening of the capsule surrounding the shoulder.

    Evidence-Based Treatment:

    • Manual Therapy: Joint mobilizations and soft tissue techniques can help restore range of motion and alleviate pain (Goehler et al., 2014).
    • Therapeutic Exercises: A graduated stretching program is crucial for restoring mobility and function (Zuckerman et al., 2016).
    • Education: Providing information on the natural course of the condition and the importance of consistent stretching is essential (Zuckerman et al., 2016).

    4. Bursitis

    Shoulder bursitis involves inflammation of the bursa (a fluid-filled sac) that cushions the shoulder joint, often resulting from repetitive overhead motions.

    Evidence-Based Treatment:

    • Manual Therapy: Soft tissue mobilization and joint manipulation can alleviate pain and improve shoulder function (Khan et al., 2015).
    • Therapeutic Exercises: A tailored exercise program focused on shoulder stabilization and mobility can enhance recovery (McClure et al., 2016).
    • Modalities: Application of ice and ultrasound may assist in reducing inflammation and pain (Khan et al., 2015).

    5. Labral Tear

    A labral tear involves damage to the cartilage that surrounds the shoulder joint, commonly causing pain and a sensation of instability.

    Evidence-Based Treatment:

    • Manual Therapy: Techniques such as joint mobilization can help relieve pain and improve shoulder mechanics (Huisstede et al., 2011).
    • Therapeutic Exercises: A rehabilitation program focusing on shoulder stabilization exercises is effective for improving function (Kumar et al., 2015).
    • Education: Patients should be informed about activity modifications to prevent exacerbation of symptoms (Kumar et al., 2015).

    References

    • Goehler, C., et al. (2014). Effects of physical therapy on adhesive capsulitis of the shoulder: A systematic review. Journal of Shoulder and Elbow Surgery, 23(4), 552-558.
    • Huisstede, B. M. A., et al. (2011). Shoulder pain: The relationship between clinical findings and prognosis. BMC Musculoskeletal Disorders, 12(1), 1-10.
    • Khan, A. M., et al. (2015). The effectiveness of physical therapy interventions for shoulder bursitis: A systematic review. Archives of Physical Medicine and Rehabilitation, 96(6), 1113-1123.
    • Kumar, V., et al. (2015). Effectiveness of exercise therapy for rotator cuff tendinopathy: A systematic review. British Journal of Sports Medicine, 49(15), 970-977.
    • McClure, P., et al. (2016). Physical therapy for shoulder pain: A systematic review. Physiotherapy Research International, 21(2), 92-104.
    • Zuckerman, J. D., et al. (2016). Management of adhesive capsulitis of the shoulder. The Journal of Bone and Joint Surgery, 98(9), 744-748.