This is the first systematic review and meta-analysis to test home-based exercise specifically for nonspecific shoulder pain. It pooled 12 randomized trials comparing home exercise alone against supervised exercise, other conservative treatments, or no treatment. Outcomes were pain intensity, function, and shoulder range of motion.
When a patient presents with nonspecific shoulder pain and no red flags, a well-designed home exercise program is a defensible first-line choice. This matters for access and cost. Supervised physical therapy demands resources and clinic time, and this analysis found no pain or function advantage over home exercise alone.
The practical mental model: teach the patient the exercises correctly once, confirm technique, then let them run the program at home. The therapeutic ingredient is the exercise, not the supervision. Resist the urge to layer on modalities. Cryotherapy, electrophysical modalities, and joint mobilization added nothing to home exercise in this data.
Weight the evidence honestly. The no-treatment and injection comparisons each rested on a single small trial with very low quality evidence, and all findings are short-term only. Midterm and long-term effects remain unknown.
This is the first systematic review and meta-analysis to test home-based exercise specifically for nonspecific shoulder pain. It pooled 12 randomized trials comparing home exercise alone against supervised exercise, other conservative treatments, or no treatment. Outcomes were pain intensity, function, and shoulder range of motion.
When a patient presents with nonspecific shoulder pain and no red flags, a well-designed home exercise program is a defensible first-line choice. This matters for access and cost. Supervised physical therapy demands resources and clinic time, and this analysis found no pain or function advantage over home exercise alone.
The practical mental model: teach the patient the exercises correctly once, confirm technique, then let them run the program at home. The therapeutic ingredient is the exercise, not the supervision. Resist the urge to layer on modalities. Cryotherapy, electrophysical modalities, and joint mobilization added nothing to home exercise in this data.
Weight the evidence honestly. The no-treatment and injection comparisons each rested on a single small trial with very low quality evidence, and all findings are short-term only. Midterm and long-term effects remain unknown.