Barriers and facilitators related to self-management of shoulder pain: a systematic review and qualitative synthesis.
Aidan O'Shea, Jonathan Drennan, Chris Littlewood and 3 others
PMID 35733369WHAT IT FOUND
Patients often abandon shoulder self-management because they expect hands-on treatment to 'fix' the problem.
Clinicians reinforce this by expressing doubt about self-care. Success requires early education that challenges these beliefs, schedules follow-up support, and aligns exercises with the patient's daily routine.
Key findings
01Patients frequently expect hands-on treatment and doubt the effectiveness of self-management, a belief reinforced when clinicians express skepticism or offer biomedical explanations.
02Adherence is facilitated by ongoing clinician support, follow-up appointments, and integrating exercises into daily routines, while lack of time and poor digital literacy are barriers.
03Clinicians often prioritize their own preferred hands-on approaches over self-management, creating a mismatch with patient needs and limiting engagement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Most included studies focused on home exercise programs, so the findings may not fully represent barriers and facilitators for broader self-management strategies. The term 'self-management' was rarely used explicitly in the original studies, meaning the review synthesized interventions that supported self-management but were not always described as such. The search may have missed relevant studies due to the broad nature of self-management, although backward and forward citation screening was used to mitigate this.
Declared interests
No funding was received. Author C. Littlewood was a co-author of three included studies and J. Sim was a co-author of one, though neither was involved in study selection.
The easy way to misread this
Do not interpret these themes as evidence that self-management programs improve clinical outcomes. This review identifies barriers and facilitators to adherence based on qualitative perceptions, not effectiveness data.