Musculoskeletal Pain Treatment Evidence Explorer

Many treatments are offered for common musculoskeletal conditions, and they are not equally supported by research. If your doctor has already diagnosed your condition, this tool shows what trials and reviews have found for each treatment option, from exercise and physiotherapy to injections and surgery, together with my own clinical observations. It does not diagnose, and it cannot replace your doctor’s assessment.

This tool does not make a diagnosis. Pain in the same area can have many causes, some of them serious.8,32 Use this tool only for a condition that your own doctor has diagnosed, and discuss any treatment choice with your doctor or physiotherapist.

Diagnosis

How the ratings work

Supported: trials or reviews show a meaningful benefit, usually over months. Short-term benefit: helps in the first weeks or months but not clearly in the long run. Mixed or uncertain: results conflict or the evidence is of low certainty. Limited evidence: too few or too small studies to say. Not better than control or placebo: tested in trials and did not outperform sham, placebo or a control treatment.

Why diagnosis comes first

Pain around the elbow, shoulder, hip, knee or neck can come from tendons, joints, nerves, the spine or, more rarely, from infection, fracture or systemic disease.8,22,32 The treatment evidence in this tool only applies once the right diagnosis has been made, which is why it asks you to confirm that your own doctor has assessed you.

References

Every figure and statement in this tool is linked to a source: the original study where my article cites one, otherwise my own article on the topic. The small numbers in the text refer to this list.

  1. Smidt et al. 2002. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. The Lancet.
  2. Bisset et al. 2006. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ.
  3. Coombes et al. 2013. Effect of Corticosteroid Injection, Physiotherapy, or Both on Clinical Outcomes in Patients With Unilateral Lateral Epicondylalgia. JAMA.
  4. Pattanittum et al. 2013. Non-steroidal anti-inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database of Systematic Reviews.
  5. Lapner et al. 2022. Nonoperative treatment of lateral epicondylitis: a systematic review and meta-analysis. JSES International.
  6. Karanasios et al. 2021. Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and meta-analysis. Clinical Rehabilitation.
  7. Kroslak and Murrell 2018. Surgical Treatment of Lateral Epicondylitis: A Prospective, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial. The American Journal of Sports Medicine.
  8. Dr. Antti Rintanen: Golfers Elbow: Causes, Diagnosis, and What the Evidence Actually Shows
  9. See et al. 2026. Eccentric exercise therapy for medial epicondylitis: A systematic review of clinical outcomes. Complementary Therapies in Medicine.
  10. Barakat et al. 2025. Systematic review of surgical techniques for medial epicondylitis: evaluating the impact of preoperative injections and concomitant ulnar neuritis on postoperative outcomes. The Annals of The Royal College of Surgeons of England.
  11. Hand et al. 2008. Long-term outcome of frozen shoulder. Journal of Shoulder and Elbow Surgery.
  12. Dr. Antti Rintanen: Frozen Shoulder: Causes, Recovery Time, and What Treatment Actually Changes
  13. Challoumas et al. 2020. Comparison of Treatments for Frozen Shoulder. JAMA Network Open.
  14. Rupani et al. 2025. British Elbow and Shoulder Society patient care pathway: Frozen shoulder. Shoulder and Elbow.
  15. Diercks and Stevens 2004. Gentle thawing of the frozen shoulder: a prospective study of supervised neglect versus intensive physical therapy in seventy-seven patients with frozen shoulder syndrome followed up for two years. J Shoulder Elbow Surg.
  16. Rangan et al. 2020. Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, three-arm, superiority randomised clinical trial. The Lancet.
  17. Sonnati et al. 2026. Overcoming Subacromial Impingement, as a Term and Concept: Rationale and Proposals. Journal of Clinical Medicine.
  18. Paavola et al. 2020. Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: a 5-year follow-up of a randomised, placebo surgery controlled clinical trial. British Journal of Sports Medicine.
  19. Karanasios et al. 2023. Manual Therapy and Exercise Have Similar Outcomes to Corticosteroid Injections in the Management of Patients With Subacromial Pain Syndrome: A Systematic Review and Meta-Analysis. Cureus.
  20. Karjalainen et al. 2019. Subacromial decompression surgery for rotator cuff disease. Cochrane Database of Systematic Reviews.
  21. Long et al. 2013. Sonography of Greater Trochanteric Pain Syndrome and the Rarity of Primary Bursitis. American Journal of Roentgenology.
  22. Dr. Antti Rintanen: Hip Bursitis: What the Evidence Shows About Lateral Hip Pain, Diagnosis and Treatment
  23. Mellor et al. 2018. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ.
  24. Lievense et al. 2005. Prognosis of trochanteric pain in primary care. Br J Gen Pract.
  25. Dr. Antti Rintanen: Iliotibial Band Syndrome: Causes, Diagnosis, and What the Evidence Says About Treatment
  26. Sanchez-Alvarado et al. 2024. Effects of conservative treatment strategies for iliotibial band syndrome on pain and function in runners: a systematic review. Frontiers in Sports and Active Living.
  27. Study cited in “Iliotibial Band Syndrome: Causes, Diagnosis, and What the Evidence Says About Treatment” (reference 18)
  28. Bolia et al. 2020. Operative Versus Nonoperative Management of Distal Iliotibial Band Syndrome—Where Do We Stand? A Systematic Review. Arthroscopy, Sports Medicine, and Rehabilitation.
  29. Crossley et al. 2016. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). British Journal of Sports Medicine.
  30. van der Heijden et al. 2015. Exercise for treating patellofemoral pain syndrome. Cochrane Database of Systematic Reviews.
  31. Esculier et al. 2017. Is combining gait retraining or an exercise programme with education better than education alone in treating runners with patellofemoral pain?A randomised clinical trial. British Journal of Sports Medicine.
  32. Dr. Antti Rintanen: Neck Pain Relief: What Actually Works, According to the Evidence
  33. de Zoete et al. 2020. Comparative effectiveness of physical exercise interventions for chronic non-specific neck pain: a systematic review with network meta-analysis of 40 randomised controlled trials. British Journal of Sports Medicine.
  34. Andersen et al. 2012. Influence of frequency and duration of strength training for effective management of neck and shoulder pain: a randomised controlled trial. British Journal of Sports Medicine.
  35. Castellini et al. 2022. Some conservative interventions are more effective than others for people with chronic non-specific neck pain: a systematic review and network meta-analysis. Journal of Physiotherapy.
  36. Dr. Antti Rintanen: SI Joint Pain: Real Problem, Over-Used Label — What the Evidence Actually Shows
  37. Tullberg et al. 1998. Manipulation does not alter the position of the sacroiliac joint. A roentgen stereophotogrammetric analysis. Spine (Phila Pa 1976).
  38. Ramírez Ramírez and Ramírez Muñoz 2023. Efecto del ejercicio terapéutico en personas con disfunción de la articulación sacroiliaca: revisión sistemática y metanálisis. Revista de la Sociedad Española del Dolor.
  39. McCormick et al. 2025. Consensus practice guidelines on sacroiliac joint complex pain from a multispecialty, international working group. Regional Anesthesia and Pain Medicine.

Sources

This tool is based on the articles below and the studies cited in them:

This tool is for general education. It does not diagnose, interpret your own situation, give personal treatment recommendations or replace an assessment by your doctor.