Effectiveness of physical agent modalities for pain relief in injured athletes: A systematic review

IntroductionFrom a rehabilitation perspective, various approaches can be applied to help athletes overcome injury, including drugs, physical agent modalities (PAMs) with conventional physical therapy. This systematic review aimed to evaluate the impact of physical agent modalities (PAMs) for pain relief in injured athletes.MethodsPubMed, Scopus, and Web of Science were systematically searched from inception until May 8^th, 2024. The papers were considered eligible for review in compliance with the conditions determined by the following PICO model: P) Participants: injured athletes; I) Intervention: magnetic therapy, TENS, lasertherapy, ultrasound therapy, diathermy, and extracorporeal shockwave therapy (ESWT); C) Comparator: NA; O) Outcome measure: any pain assessment. PROSPERO registration number: CRD42024532304ResultsStudy selection reported a total of 785 records, resulting in 484 articles after duplicate removal. After the title and abstract screening, 433 papers were excluded and 51 articles were evaluated for eligibility. Therefore, 21 studies were included, involving a total of 806 subjects: 10 ESWT, 1 Cryotherapy, 2 Cryo + ultrasound, 3 diathermy, 1 NMES, 1 TENS, 2 Laser therapy, 1 combined procedure.ConclusionsThe systematic review indicated potential effectiveness of PAMs in managing and reducing pain in sport-related injuries. Taken together, our findings suggested a positive role of ESWT in term of pain relief, also considering that these PAMs are the most used in these subjects. However, the high heterogeneity of the results could not consent to define the specific effect of the single PAMs.