Shock Wave Therapy for Calcific Tendinitis of the Shoulder

2003 ◽  
Vol 31 (3) ◽  
pp. 425-430 ◽  
Author(s):  
Ching-Jen Wang ◽  
Kuender D. Yang ◽  
Feng-Sheng Wang ◽  
Han-Hsiang Chen ◽  
Jun-Wen Wang

Background Shock wave therapy is a new modality that has shown efficacy in the treatment of various orthopaedic disorders. Purpose To determine the effectiveness, at 2- to 3-year follow-up, of shock wave therapy for calcific tendinitis of the shoulder. Study Design Prospective clinical study. Methods Thirty-seven patients (39 shoulders) with calcific shoulder tendinitis were treated with shock wave therapy (1000 impulses at 14 kV) and observed for 24 to 30 months. The control group, which underwent sham treatment with a dummy electrode, consisted of 6 patients (6 shoulders) with an average follow-up of 6 months. Evaluation included use of the 100-point Constant score system and shoulder radiographs. Results The overall results in the study group were 60.6% excellent (20 of 33 shoulders), 30.3% good (10), 3.0% fair (1), and 6.1% poor (2), and those of the control group were 16.7% fair (1 of 6 shoulders) and 83.3% poor (5). The symptom recurrence rate in the study group was 6.5%. Dissolution of calcium deposits was complete in 57.6% of the study group, partial in 15.1%, and unchanged in 27.3%. Fragmentation was seen in 16.7% of the control group patients; in 83.3% deposits were unchanged. No recurrence of calcium deposits was observed during the 2 years that the study group was followed. Conclusions Shock wave therapy is a safe and effective noninvasive treatment for patients with calcific tendinitis of the shoulder.

2006 ◽  
Vol 86 (5) ◽  
pp. 672-682 ◽  
Author(s):  
Angelo Cacchio ◽  
Marco Paoloni ◽  
Antonio Barile ◽  
Romildo Don ◽  
Fosco de Paulis ◽  
...  

Abstract Background and Purpose. Radial shock-wave therapy (RSWT) is a pneumatically generated, low- to medium-energy type of shock-wave therapy. This single-blind, randomized, “less active similar therapy”-controlled study was performed to evaluate the effectiveness of RSWT for the management of calcific tendinitis of the shoulder. Subjects. Ninety patients with radiographically verified calcific tendinitis of the shoulder were tested. Methods. Subjects were randomly assigned to either a treatment group (n=45) or a control group (n=45). Pain and functional level were evaluated before and after treatment and at a 6-month follow-up. Radiographic modifications in calcifications were evaluated before and after treatment. Results. The treatment group displayed improvement in all of the parameters analyzed after treatment and at the 6-month follow-up. Calcifications disappeared completely in 86.6% of the subjects in the treatment group and partially in 13.4% of subjects; only 8.8% of the subjects in the control group displayed partially reduced calcifications, and none displayed a total disappearance. Discussion and Conclusion. The results suggest that the use of RSWT for the management of calcific tendinitis of the shoulder is safe and effective, leading to a significant reduction in pain and improvement of shoulder function after 4 weeks, without adverse effects.


2002 ◽  
Vol 30 (3) ◽  
pp. 422-425 ◽  
Author(s):  
Ching-Jen Wang ◽  
Han-Shiang Chen

Background The results of both nonoperative and surgical treatments for lateral epicondylitis of the elbow have been inconsistent. Shock wave therapy has been shown to have a favorable short-term effect in treating this condition. Hypothesis Shock wave therapy is an effective treatment for patients with lateral epicondylitis of the elbow and long-term results will be as favorable as short-term ones. Study Design Case series. Methods The effect of shock wave therapy was investigated in 57 patients with lateral epicondylitis of the elbow. Forty-three patients (24 men and 19 women with an average age of 46 years) with 1 to 2 years of follow-up were included in this study. In addition, six patients were treated with a sham procedure as a control group. Each patient was treated with 1000 impulses of shock wave therapy at 14 kV to the affected elbow. A 100-point scoring system was used for evaluating pain, function, strength, and elbow range of motion. Results Twenty-seven elbows (61.4%) were free of complaints, 13 (29.5%) were significantly better, 3 (6.8%) were slightly better, and 1 (2.3%) was unchanged. In the control group, the results were unchanged in all six patients. There were no device-related problems and no systemic or local complications. Conclusions Shock wave therapy is a safe and effective modality in the treatment of patients with lateral epicondylitis of the elbow.


Author(s):  
Christina Gesslbauer ◽  
Michael Mickel ◽  
Othmar Schuhfried ◽  
Dominikus Huber ◽  
Mohammad Keilani ◽  
...  

Summary Background The carpal tunnel syndrome is the most common entrapment neuropathy in the general population. A conservative treatment should be considered in mild to moderate cases. The aim of this study was to assess the effect of a focused extracorporeal shock wave therapy in the treatment of mild to moderate carpal tunnel syndrome. Material and Methods In this study 30 patients were randomly assigned into 2 groups. Subjects in the study group received three sessions of focused extracorporeal shock wave therapy, whereas the control group underwent a sham therapy. Patients were evaluated 3 and 12 weeks after treatment. The primary outcome was the visual analogue scale score. Secondary outcome measurements included hand grip strength, Boston Carpal Tunnel Syndrome Questionnaire, SF-36 Health Survey and electrodiagnostic measurements. Results A significant improvement of visual analogue scale at week 3 (p = 0.018) and week 12 (p = 0.007) as well as hand grip strength at week 12 (p = 0.019) could be observed in the study group. The study group showed a significantly better sensory nerve conduction velocity at week 12 than the control group, before correcting for multiple testing, and also a significant improvement in distal motor latency of the median nerve at week 12 (p = 0.009) as well as in both questionnaires (SF-36 subscale bodily pain, p = 0.020 and severity symptom scale, p = 0.003). No such improvement was observed in the control group. Conclusion Focused extracorporeal shock wave therapy is an effective and noninvasive treatment method for mild to moderate carpal tunnel syndrome.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Bożena Dziankowska-Bartkowiak ◽  
Michał Podgórski ◽  
Jarosław Fabiś ◽  
Arleta Waszczykowska

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.


2020 ◽  
Vol 47 (1) ◽  
Author(s):  
Samah M. Alian ◽  
Rabab S. Zaghlol ◽  
Sahar S. Khalil

Abstract Background To compare the clinical efficacy of platelet rich plasma (PRP) subacromial injection and extracorporeal shock wave therapy (ESWT) on refractory non-calcific partial thickness supraspinatous tendon tear. Results Significant improvement in all outcome measures achieved in both groups at 4 weeks follow-up period (the end of treatment course) (P< 0.05). At 12 weeks follow-up period, group I, showed significant improvement in all outcome measures compared to baseline and group II; however, in group II, there was no significant difference compared to baseline; moreover, deterioration in the previous improvement was noticed. Conclusion Both PRP (group I) and ESWT (group II) are effective therapeutic methods in the management of refractory non-calcific partial thickness supraspinatous tendon tear; however, PRP (group I) has better long-term effects on both pain and function.


2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0021
Author(s):  
Mauricio Drummond ◽  
Caroline Ayinon ◽  
Albert Lin ◽  
Robin Dunn

Objectives: Calcific tendinitis of the shoulder is a painful condition characterized by the presence of calcium deposits within the tendons of the rotator cuff (RTC) that accounts for up to 7% of cases of shoulder pain1. The most common conservative treatments typically include physical therapy (PT), corticosteroid injection (CSI), or ultrasound-guided aspiration (USA). When conservative management fails, the patient may require arthroscopic surgery to remove the calcium with concomitant rotator cuff repair. The purpose of this study was to characterize the failure rates, defined as the need for surgery, of each of these three methods of conservative treatment, as well as to compare post-operative improvement in patient-reported outcomes (PROs) – including subjective shoulder values (SSV) and visual analog scale (VAS) pain scores – based on the type of pre-operative conservative intervention provided. A secondary aim was to compare post-operative range of motion (ROM) outcomes between groups that failed conservative management. We hypothesized that all preoperative conservative treatments would have equivalent success rates, PROs, and ROM. Bosworth B. Calcium deposits in the shoulder and subacromial bursitis: a survey of 12122 shoulders. JAMA. 1941;116(22):2477-2489. Methods: A retrospective review of all patients who were diagnosed with calcific tendinitis at our institution treated among 3 fellowship trained orthopedic surgeons between 2009 and 2019 was performed. VAS, SSV, and ROM in forward flexion (FF) and external rotation (ER) was abstracted from the medical records. Scores were recorded at the initial presentation as well as final post-operative follow-up visit for those who underwent surgery. The conservative treatment method utilized by each patient was recorded and included PT, CSI, or USA. Failure of conservative management was defined as eventual progression to surgical intervention. Statistical analysis included chi-square, independent t test and ANOVA. Descriptive statistics were used to report data. A p<0.05 was considered to be statistically significant. Results: 239 patients diagnosed with calcific tendinitis were identified in the study period with mean age of 54 years and follow up of at least 6 months. In all, 206 (86.2%) patients underwent a method of conservative treatment. Of these patients, 71/239 (29.7%) underwent PT, 67/239 (28%) attempted CSI, and 68/239 (28.5%) underwent USA. The overall failure rate across all treatment groups was 29.1%, with injections yielding the highest success rate of 54/67 (80.6%). Physical therapy saw the highest failure rate, with 26/71 (36.7%) proceeding to surgical intervention. Patients undergoing physical therapy were statistically more likely to require surgery compared to those undergoing corticosteroid injection (RR 1.88, p= 0.024). Of all 93 patients who underwent surgery, VAS, SSV, ROM improved significantly in all groups. On average, VAS decreased by 4.02 points (6.3 to 2.3), SSV increased by 33 points (51 to 84), FF improved by 13.8º, and ER improved 8.4º between the pre- and post-operative visits (p<0.05). The 33 patients who did not attempt a conservative pre-operative treatment demonstrated the largest post-operative improvement in VAS (-6.00), which was significantly greater than those who previously attempted PT (-3.33, p<0.05). There was a trend towards greater improvement in SSV in the pre-operative PT group (45 to 81) compared to others, but this did not reach statistical significance (p=0.47). Range of motion was not significantly affected by the method of pre-operative conservative intervention. Conclusions: Conservative treatment in the form of physical therapy, corticosteroid injection, and ultrasound-guided aspiration is largely successful in managing calcific tendinitis of the shoulder. Of these, PT demonstrated the highest rate of failure in terms of requiring surgical management. PRO improvement varied among the conservative modalities used, however patients who did not attempt conservative management experienced the greatest improvements following surgery. If surgery is necessary following failed conservative treatment, excellent outcomes can be expected with significant improvements in ROM and PROs. This information should be considered by the surgeon when deciding whether to recommend conservative treatment for the management of calcific tendinitis, as well as which specific method to employ.


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