Comparative Effectiveness of Treatment Options for Subacromial Shoulder Conditions: A Network Meta-Analysis

Various treatment options are available for the primary care management of subacromial shoulder conditions, including advice and education, medication, exercise therapies, steroid (cortisone) injections, and referral for surgical opinion. However, it is not easy for general practitioners and patients to decide between these treatment options, as there is limited evidence indicating which treatment is best. A large number of studies (trials) have investigated the effectiveness of shoulder pain treatments, but few studies have directly compared different treatment options. The aim of this systematic review is to summarize the results of all previously conducted trials, looking at outcomes that are relevant to patients (pain, function, return to work), and use advanced statistical methods to combine the results from existing trials. The analysis will make it possible to rank treatment options based on their effectiveness. If the included trials provide sufficient information we will also carry out these analyses for important subgroups of patients, for example for those with short-lasting versus more persistent shoulder pain; or older versus younger patients.

The systematic review will also identify any gaps in the evidence, and identify treatments that require investigation in future trials. We will involve clinicians and shoulder pain patients when interpreting the results and reporting the findings and conclusions of the review.