Short-term outcomes of extracorporeal shock wave therapy for the treatment of chronic non-calcific tendinopathy of the supraspinatus: a double-blind, randomized, placebo-controlled trial.
BACKGROUND
There is evidence supporting the use of extracorporeal shock wave therapy (ESWT) in calcific tendinopathy of the rotator cuff, but the best current evidence does not support its use in non-calcifying tendinopathy. We conducted a randomized placebo-controlled trial to investigate the efficacy and safety of low energy ESWT for non-calcifying tendinopathy of the rotator cuff.


METHODS
20 patients with non-calcifying supraspinatus tendinopathy (NCST) were randomized to an active or a sham treatment group. Physical, blood, roentgenographic, and MRI examinations of the shoulder were conducted to verify that patients met the inclusion and exclusion criteria. These examinations were repeated six and twelve weeks after treatments. Effectiveness was determined by comparison of the mean improvement in the Constant and Murley score (CMS) between the treatment and the placebo groups at three months. Safety was assessed by analyzing the number and severity of adverse events.


RESULTS
All the patients completed the investigation protocol. At the final follow-up, significant improvement in the total CMS score and most of the CMS subscales was observed in the ESWT group when compared to the baseline values. Significantly higher total CMS, and significantly higher scores for CMS pain and ROM were observed in the ESWT group when compared to the placebo. No serious adverse events were noted after ESWT.


CONCLUSIONS
Patients suffering from NCST may benefit from low energy ESWT, at least in short-term. The application protocol of ESWT is likely to play a key-role in a successful treatment. Future investigations should be undertaken on the long-term effects of this technique for the treatment of NCST.


BACKGROUND
Current Controlled Trials ISRCTN41236511.
Department of Orthopaedic and Trauma Surgery, Magna Græcia University, V.le Europa88100, Catanzaro, Italy. galasso@unicz.it
Olimpio
O
Galasso
Ernesto
E
Amelio
Daria Anna
DA
Riccelli
Giorgio
G
Gasparini
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011859:Radiography; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000503:physiopathology; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000503:physiopathology; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome