• Eduardo Signorini Bicas Franco, Maria Eduarda Dos Santos Puga, Aline Mizusaki Imoto, Jhony de Almeida, Vitor da Mata, and Stella Peccin.
• MSc. Doctoral Student and Physiotherapist, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
• Sao Paulo Med J. 2019 Nov 1; 137 (6): 543549543-549.

BackgroundShoulder pain is considered to be the third largest cause of musculoskeletal functional alterations in individuals presenting pain during movement.ObjectiveThe purpose of this synthesis of evidence was to identify the clinical effectiveness of conservative and surgical treatments reported in Cochrane systematic reviews among individuals diagnosed with rotator cuff disease.Designand SettingReview of systematic reviews, conducted in the Federal University of São Paulo (Universidade Federal de São Paulo, UNIFESP).MethodsThis synthesis of evidence included systematic reviews that had been published in the Cochrane database. The inclusion criteria were that these systematic reviews should involve individuals aged ≥ 16 years with rotator cuff disease, comparing surgical procedures with or without associated nonsurgical procedures versus placebo, no treatment or other nonsurgical interventions.ResultsThirty-one systematic reviews were included, involving comparisons between surgical procedures and conservative treatment; procedures either combined or not combined with drugs, versus other procedures; and procedures involving exercises, manual therapy and electrothermal or phototherapeutic resources.ConclusionsThe findings suggest that strengthening exercises, with or without associated manual therapy techniques and other resources, were the interventions with greatest power of treatment over the medium and long terms, for individuals with shoulder pain. These had greater therapeutic power than surgical procedures, electrotherapy or photobiomodulation.Protocol registration number in the PROSPERO database: ID - CRD42018096578.

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