A recent review of the research surrounding effective treatments for shoulder pain (also known as subacromial impingement, rotator cuff tendinopathy or shoulder bursitis) was published in the Journal of Orthopaedics and Sports Physiotherapy (JOSPT).

The authors found that the literature currently supports:

  • Exercise therapy should be prioritised as the primary treatment option, due to its clinical effectiveness, cost effectives, and other associated health benefits
  • Conflicting evidence surrounds the effectiveness of corticosteroid injection
  • Ultrasound, low level laser and extracorporeal shock wave therapy lack evidence of 331 effectiveness

What about surgery?

Another review Published in the Public Library of Science (PLOS 1) looked at whether adding surgical interventions to physical therapy improved outcomes and pain.

The findings were:

  • The effects of surgery plus physiotherapy compared to physiotherapy alone on improving pain and function are too small to be clinically important at 3-, 6-months, 1-, 2-, 5- and 10-years follow up.
  • Similarly, surgery plus physiotherapy vs placebo (surgery) plus physiotherapy comparison demonstrated no clinically important differences in terms of improving pain or function at 3-, 6-months, 1-, 2-years follow up.
  • The evidence suggests that physiotherapy treatment programs (with exercise component) be considered as the first treatment approach

What does this mean for you?

If you are suffering from shoulder pain, or have been diagnosed with any of the conditions discussed in this article, talking with your GP or a qualified exercise professional about the suitability of exercise therapy, as a treatment option may be your best plan.


  1. Pieters, L., Lewis, J., Kuppens, K., Jochems, J., Bruijstens, T., Joossens, L. and Struyf, F., 2019. An update of systematic reviews examining the effectiveness of conservative physiotherapy interventions for subacromial shoulder pain. Journal of Orthopaedic & Sports Physical Therapy, (0), pp.1-33.
  2. Nazari, G., MacDermid, J.C., Bryant, D. and Athwal, G.S., 2019. The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis. PloS one14(5).