Effect of Mirror Therapy for Patients With Shoulder Pain: A Scoping Review

Mirror therapy (MT) is a noninvasive intervention that uses visual feedback to induce cortical reorganization and was initially applied to reduce phantom pain. More recently, MT has been adopted for upper limb rehabilitation, including shoulder disorders. While individual studies have suggested potential benefits of MT for pain and range of motion (ROM), no review has specifically focused on its use in patients with shoulder pain. This scoping review aimed to map the existing literature on MT in this population and identify knowledge gaps to guide future research. Searches were conducted in the Cochrane Controlled Register of Trials (CENTRAL), MEDLINE, and Scopus databases to identify studies published up to September 2024. To capture the most recent evidence, an additional search was performed in September 2025 to include studies released between September 2024 and September 2025. Study selection was independently carried out by two reviewers according to predefined eligibility criteria. Data were extracted on study characteristics, participant demographics, and outcomes related to the use of MT for musculoskeletal shoulder pain. The review process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Of the 127 records identified, three studies met the inclusion criteria: two randomized controlled trials and one case series. Two studies investigated patients with adhesive capsulitis, and one study included individuals with nonspecific shoulder pain. Intervention protocols varied in frequency and duration, with session lengths ranging from three to 20 minutes and follow-up periods from one day to 10 weeks. Pain and ROM were the most commonly assessed outcomes, whereas functional, psychological, and quality-of-life measures were inconsistently reported. MT interventions generally involved active flexion, abduction, internal rotation, and external rotation of the unaffected limb viewed in a mirror. Reported findings suggest short-term improvements in pain and ROM; however, evidence for superiority over other interventions remains inconclusive. This scoping review highlights the emerging evidence on MT for patients with shoulder pain, particularly those with adhesive capsulitis. MT has been investigated primarily for its potential to improve pain and ROM, with functional outcomes assessed in only a limited number of studies. However, psychological and quality-of-life measures have rarely been evaluated, and heterogeneity in patient populations, intervention protocols, and outcome assessments limits comparability across studies. Future high-quality randomized controlled trials with standardized protocols and comprehensive outcome measures are needed to clarify the clinical effectiveness of MT and to define its role in rehabilitation practice.