Comparative Effectiveness of Packages of Treatment Including Ultrasound or Transcutaneous Electrical Nerve Stimulation in Painful Shoulder Syndrome

Summary Painful shoulder syndrome (PSS) is a common problem in rheumatology and physiotherapy. Ultrasound (US) and transcutaneous electrical nerve stimulation (TENS) have been advocated as potentially useful in pain management but this has not been adequately demonstrated. A randomised clinical trial was designed to compare their effectiveness in a package of treatment for PSS. Thirty patients with untreated PSS were randomly allocated to groups which received either US to the glenohumeral joint for ten minutes or TENS on the anterior and posterior aspects of the joint for 20 minutes for 13 sessions. All patients performed Codman (pendular) and stretching exercises and received superficial heat treatment. Before-and-after measurements of range of movement and pain were collected and compared. A statistically significant and clinically important improvement in pain and range of flexion was shown for both packages of treatment but no statistically significant difference was found between them. It is concluded that packages of treatment including pendular exercises, superficial heat and either TENS or ultrasound are effective therapeutic alternatives for relief of PSS.