Extracorporeal shock wave therapy for chronic calcific tendinitis of the shoulders: a functional and sonographic study.
OBJECTIVE
To evaluate the therapeutic effect of extracorporeal shock wave therapy (ESWT) in shoulders with chronic calcific tendinitis, to compare the functional outcomes of ESWT and transcutaneous electric nerve stimulation (TENS) therapy, and to investigate which types of calcium deposit effectively respond to ESWT.


METHODS
Randomized controlled trial.


METHODS
Outpatient clinics of the departments of physical medicine and rehabilitation and of orthopedics and traumatology of a veterans hospital in Taiwan.


METHODS
Sixty patients with continuous shoulder pain for 6 months or more and with radiographically and sonographically verified calcific tendinitis. Patients were randomly allocated to receive ESWT (33 shoulders) or TENS treatment (30 shoulders).


METHODS
ESWT was performed with 2000 shock waves at 2Hz and energy level between.26 and.32mJ/mm(2) per session. Treatment was given in 2 sessions, 14 days apart. TENS therapy was given 3 times a week for 4 weeks.


METHODS
Mean Constant score, visual analog scale (VAS), manual muscle test, and changes of sonographic size and shape of calcium deposits were calculated for 4 time points: at baseline, 2 weeks, 4 weeks, 12 weeks posttherapy.


RESULTS
In both groups, Constant score and VAS improved significantly at 2-, 4-, and 12-week follow-ups (P<.05), and the size of calcium deposits decreased significantly at the 4- and 12-week follow-ups. Moreover, the arc-shaped calcific plaques of the rotator cuff were markedly meliorated with ESWT.


CONCLUSIONS
ESWT is more effective in the treatment of chronic calcific tendinitis of the shoulder than is TENS therapy, especially for arc-type calcific plaque.
Pan
Po-Jung
PJ
Departments of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan. cl_chou@vghtpe.gov.tw
Chou
Chen-Liang
CL
Chiou
Hong-Jen
HJ
Ma
Hsiao-Li
HL
Lee
Hui-Chen
HC
Chan
Rai-Chi
RC
D000203:Activities of Daily Living; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012399:Rotation; D017006:Rotator Cuff; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013624:Taiwan; D052256:Tendinopathy / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods / Q000592:standards; D016896:Treatment Outcome; D014463:Ultrasonography