Pulsed Ultrasound May Resolve Calcific Shoulder Tendinitis
Calcific tendinitis of the shoulder, a reactive calcification affecting the rotator cuff tendons, can cause shoulder pain, range-of-motion restrictions and functional limitations. While numerous treatments have been advocated, evidence regarding their efficacy is largely anecdotal.
After noting improvement of symptoms in calcific tendinitis following ultrasound, researchers sought to test the therapy by way of a randomized clinical trial.
Fifty-four patients (61 shoulders) received either pulsed ultrasound (0.89 MHz, 2.5 W/cm2, 1:4 pulse mode ratio, 15 minutes) or a sham treatment (the same as the ultrasound group, but with the machine not turned on).
Thirty-two shoulders were treated with ultrasound five times a week for three weeks, then three times a week for three weeks; the remaining 29 shoulders received the sham treatment.
The ultrasound group demonstrated a statistically significant improvement compared to the sham group. After six weeks of treatment, calcium deposits had resolved in six shoulders in the ultrasound group and decreased by at least 50% in nine shoulders. By comparison, none of the shoulders in the sham group showed calcium resolution, and only three showed 50% improvement. At a nine-month follow-up, these differences were even greater (ultrasound group: resolution in 13 shoulders, improvement in 7 shoulders; sham group: resolution in 2 shoulders, improvement in 3 shoulders).
Conclusion? Using the authors' parameters for calcific tendinitis, ultrasound treatment is an effective, noninvasive method of managing calcific tendinitis of the shoulder, particularly in achieving short-term reductions in symptoms.
Ebenbichler G, Erdogmus CB, Resch KL, et al. Ultrasound therapy for calcific tendinitis of the shoulder. The New England Journal of Medicine
, May 20, 1999:340(20), pp1533-1538.