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Effectiveness of Radial Shock-Wave Therapy for Calcific Tendinitis of the Shoulder: Single-Blind, Randomized Clinical Study

A Cacchio, MD, is Assistant of PM&R, Department of Neuroscience, Physical Medicine and Rehabilitation Unit, "San Salvatore" Hospital of L’Aquila, Coppito-L’Aquila, Italy, and Assistant of PM&R, Department of Physical Medicine and Rehabilitation, School of Medicine, "La Sapienza" University of Roma, Rome, Italy
M Paoloni, MD, is Assistant of PM&R, Department of Physical Medicine and Rehabilitation, School of Medicine, "La Sapienza" University of Roma
A Barile, MD, is Researcher of Radiology, Department of Radiology, School of Medicine, University of L’Aquila
R Don, MD, is Assistant of PM&R, Department of Physical Medicine and Rehabilitation, School of Medicine, "La Sapienza" University of Roma
F de Paulis, MD, is Chief of Radiology at CT Unit, Department of Radiology, "San Salvatore" Hospital of L’Aquila
V Calvisi, MD, is Professor of Orthopaedic Surgery, Department of Surgery, Orthopaedic Surgery, School of Medicine, University of L’Aquila
A Ranavolo, MEng, is Researcher of Biomechanics, Department of Physical Medicine and Rehabilitation, School of Medicine, "La Sapienza" University of Roma
M Frascarelli, MD, is Professor of PM&R, Department of Physical Medicine and Rehabilitation, School of Medicine, "La Sapienza" University of Roma
V Santilli, MD, is Professor and Chief of PM&R Unit, Department of Physical Medicine and Rehabilitation, School of Medicine, "La Sapienza" University of Roma
G Spacca, MD, is Chief of PM&R Unit, Department of Neuroscience, Physical Medicine and Rehabilitation Unit, "San Salvatore" Hospital of L’Aquila

(angelo.cacchio{at}tin.it) Address all correspondence to Dr Cacchio Angelo at Dipartimento di Neuroscienze, Unità Operativa di Medicina Fisica e Riabilitazione, Ospedale "San Salvatore" di L’Aquila, via L.Natali 1, 67100 Coppito-L’Aquila, Italy

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.

Key Words: Calcific tendinitis • Lithotripsy • Radial shock-wave therapy • Rotator cuff • Shoulder

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