Shock therapy improves pain and function in patients with chronic calcific shoulder tendinitis, according to an article published in Annals of Internal Medicine. Rotator cuff tendonitis is one of the most common causes of shoulder pain and may present with or without calcifications. There is little evidence to suggest that conventional therapies, such as rest, ice, nonsteroidal anti-inflammatory drugs, physical therapy, and subacromial corticosteroid injections can effectively ease pain or restore function. Calcific tendinitis, in particular, may be more difficult to manage and may require surgery. Extracorporeal shockwave therapy (ESWT), which uses sound waves of high or low energy that impart rapid fluctuations of pressure to tissues, has been suggested as an alternative treatment to expensive and risky surgical interventions.
Researchers reviewed 28 published randomized, controlled trials to assess the efficacy of ESWT in patients with calcific and noncalcific tendinitis. For calcific tendinitis, high-energy ESWT seemed to improve shoulder pain, function, and calcifications, whereas low-energy ESWT seemed to improve only function. Conversely, ESWT did not appear to be effective in treating noncalcific tendinitis, regardless of energy dose. The evidence suggests that ESWT is a safe treatment, with no serious adverse effects reported.
High-Energy Extracorporeal Shock-Wave Therapy for Treating Chronic Calcific Tendinitis of the Shoulder: A Systematic Review, R.R. Bannuru, N.E. Flavin, E. Vaysbrot, W. Harvey, and T. McAlindon, Annals of Internal Medicine, DOI: 10.7326/M13-1982, published online 14 April 2014.