Cochrane Summaries

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Exercises, ergonomics and physical therapy for work-related complaints of arm, neck or shoulder

Verhagen AP, Bierma-Zeinstra SMA, Burdorf A, Stynes SM, de Vet HCW, Koes BW
Published Online: 
12 December 2013


Work-related complaints of the arm, neck or shoulder are also called repetitive strain injury or occupational overuse syndrome. They are a burden for individual workers, for their employers and for society at large because they impair functioning both in daily life and at work.

Studies included in the review

We included randomised controlled studies of all possible treatments such as exercises, ergonomic adjustments at the workplace, massage and manual therapy. These treatments aim to reduce pain and improve functioning, and they can be provided by general practitioners or physiotherapists. We excluded injections and surgical procedures that invade the body and require more special skills. We included studies only if the authors wrote that the people they studied had complaints that were work-related. We searched electronic databases up until May 2013.


We found 44 studies that included 6,580 persons. Twenty-one studies evaluated exercises, 13 evaluated ergonomic workplace adjustments and nine behavioural interventions. We combined the results of these studies per category. Eight other studies evaluated various other treatments.

We did not find a consistent effect of any treatment on pain, recovery, disability or sick leave. Ergonomic interventions reduced pain in the long term but not in the short term in several studies. We judged nine studies to be of high quality, but the results were very inconsistent. We found no reason for the variation in study results. Better studies are needed that are bigger, have a clearer diagnosis of work-relatedness and comply with reporting guidelines.

This record should be cited as: 
Verhagen AP, Bierma-Zeinstra SMA, Burdorf A, Stynes SM, de Vet HCW, Koes BW. Conservative interventions for treating work-related complaints of the arm, neck or shoulder in adults. Cochrane Database of Systematic Reviews 2013, Issue 12. Art. No.: CD008742. DOI: 10.1002/14651858.CD008742.pub2
Assessed as up to date: 
29 November 2013