Upper Extremity

Updated: July 2021

Clinical Practice Guidelines (CPG)

  • A 2021 Canadian CPG made recommendations for noninvasive management of soft tissue disorders of the shoulder. Recommended treatment for shoulder pain included low-level laser therapy, multimodal care including heat, cold, range of motion exercises, spinal manipulation to cervicothoracic spine for restricted joint movement, mobilization of shoulder. Manipulation was not recommended as an adjunct to exercise based on 1 randomized controlled trial that concluded that it did not provide an added benefit. For conditions greater than 3 months’ duration, additional strengthening exercises and laser acupuncture are recommended and if necessary, pharmacological pain management. Shock-wave therapy should be considered for calcific tendonitis. The guideline recommends against ultrasound therapy, taping, interferential current therapy. ABSTRACT

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A literature synthesis of Chiropractic Care for Upper Extremities — an academically rigorous analysis of all the available scientific literature using internationally accepted tools to rate each article according to specific criteria indicating only what we can conclude with supportable, scientific evidence.