Effects of Extracorporeal Shock Wave Therapy, Photobiomodulation, Ultrasound, and Electrotherapy Modalities on Rotator Cuff-Related Shoulder Pain: A Systematic Review.
- 1Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria.
- 2Department of Sport Science and Health, University of Teacher Education Carinthia, 9020 Klagenfurt am Wörthersee, Austria.
Abstract
Background and Objectives: The term rotator cuff-related shoulder pain (RCRSP) refers to pain localized in the deltoid region. RCRSP and the associated pain and functional limitations have a significant impact on the quality of life of those affected. This systematic review aimed to investigate the treatment and follow-up effects of extracorporeal shock wave therapy (ESWT), photobiomodulation (PBM), ultrasound (US), and electrotherapy modalities (ET) in RCRSP. Methods: A comprehensive literature search was conducted. In addition, the reference lists of the included studies and relevant reviews were screened to identify further eligible studies (snowballing). Randomized controlled trials (RCTs) investigating the treatment and follow-up effects of ESWT, PBM, US, and ET for RCRSP, with control groups receiving sham or alternative physiotherapeutic treatments, were included without restrictions on date or language. Two reviewers independently conducted the literature screening, data extraction, and risk-of-bias assessment for the included studies. The differences in pain between pre- and post-intervention, the between-group differences (intervention vs. control), as well as subgroups (low-level laser therapy [LLLT] and high-power laser therapy [HPLT]) were analyzed. Results: A total of 20 RCTs with 1153 patients were included. Quality assessment indicated a low risk of bias in 55% of the included studies, some concerns in 35%, and high risk in 10%. In the nature of a sustainable therapy, therapeutic modalities were mostly not applied in isolation but rather in combination with conventional physiotherapeutic interventions. One study showed an end-of-treatment pain reduction for ESWT, and one study showed no follow-up effect on pain. PBM showed a significant but small end-of-treatment effect and an insignificant follow-up effect. The subgroup analysis suggested that only HPLT demonstrated a clear end-of-treatment effect. Due to the limited number of studies, no subgroup analysis could be performed for follow-up outcomes. US showed beneficial small effects both at the end of treatment and at follow-up, while ET demonstrated an end-of-treatment effect. Further studies are needed for the follow-up effect. Conclusions: HPLT, US, and ET showed consistent additive treatment effects, while PBM and US showed follow-up effects. In general, especially for PBM, ESWT, and ET, more studies are needed to gain a broader insight into this topic.
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BibTeX
@article{buhl2026effects,
title = {{Effects of Extracorporeal Shock Wave Therapy, Photobiomodulation, Ultrasound, and Electrotherapy Modalities on Rotator Cuff-Related Shoulder Pain: A Systematic Review.}},
author = {Dennis Bühl and Alexandra Unger and Andreas Konrad},
journal = {Journal of functional morphology and kinesiology},
year = {2026},
month = sep,
doi = {10.3390/jfmk11040383},
url = {https://europepmc.org/article/MED/42924662},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of Extracorporeal Shock Wave Therapy, Photobiomodulation, Ultrasound, and Electrotherapy Modalities on Rotator Cuff-Related Shoulder Pain: A Systematic Review.
AU - Dennis Bühl
AU - Alexandra Unger
AU - Andreas Konrad
PY - 2026
DA - 2026/09/24
JO - Journal of functional morphology and kinesiology
DO - 10.3390/jfmk11040383
UR - https://europepmc.org/article/MED/42924662
AB - Background and Objectives: The term rotator cuff-related shoulder pain (RCRSP) refers to pain localized in the deltoid region. RCRSP and the associated pain and functional limitations have a significant impact on the quality of life of those affected. This systematic review aimed to investigate the treatment and follow-up effects of extracorporeal shock wave therapy (ESWT), photobiomodulation (PBM), ultrasound (US), and electrotherapy modalities (ET) in RCRSP. Methods: A comprehensive literature search was conducted. In addition, the reference lists of the included studies and relevant reviews were screened to identify further eligible studies (snowballing). Randomized controlled trials (RCTs) investigating the treatment and follow-up effects of ESWT, PBM, US, and ET for RCRSP, with control groups receiving sham or alternative physiotherapeutic treatments, were included without restrictions on date or language. Two reviewers independently conducted the literature screening, data extraction, and risk-of-bias assessment for the included studies. The differences in pain between pre- and post-intervention, the between-group differences (intervention vs. control), as well as subgroups (low-level laser therapy [LLLT] and high-power laser therapy [HPLT]) were analyzed. Results: A total of 20 RCTs with 1153 patients were included. Quality assessment indicated a low risk of bias in 55% of the included studies, some concerns in 35%, and high risk in 10%. In the nature of a sustainable therapy, therapeutic modalities were mostly not applied in isolation but rather in combination with conventional physiotherapeutic interventions. One study showed an end-of-treatment pain reduction for ESWT, and one study showed no follow-up effect on pain. PBM showed a significant but small end-of-treatment effect and an insignificant follow-up effect. The subgroup analysis suggested that only HPLT demonstrated a clear end-of-treatment effect. Due to the limited number of studies, no subgroup analysis could be performed for follow-up outcomes. US showed beneficial small effects both at the end of treatment and at follow-up, while ET demonstrated an end-of-treatment effect. Further studies are needed for the follow-up effect. Conclusions: HPLT, US, and ET showed consistent additive treatment effects, while PBM and US showed follow-up effects. In general, especially for PBM, ESWT, and ET, more studies are needed to gain a broader insight into this topic.
SN - 2411-5142
ER -