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Extracorporeal Shockwave treatment is effective in calcific tendonitis of the shoulder. A randomized controlled trial

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Summary

Background

Calcific tendonitis of the shoulder is often associated with chronic pain and impairment of function. Extracorporeal Shockwave therapy (ESWT) is considered to be a treatment option. We compared the effects of two different ESWT regimens.

Methods

43 patients (57 shoulders) with symptomatic calcific tendonitis of the shoulder for more than six months were included in a double-blinded study. Thirty-one shoulders were treated at the area of maximum pain with application of 2×2000 impulses of 0.28mJ/mm2 at an interval of two weeks (treatment group) and 26 shoulders with 2×2000 impulses of <0.07mJ/mm2 at an interval of two weeks (control group), without pretreatment analgesia. Shoulder function (Constant score) and pain (visual analogue scale, VAS) were assessed before treatment and at one week, three months and seven months after treatment. Shoulder X-rays were performed at the 3- and 7-month follow-up visits.

Results

Improvement in Constant score was significantly higher in the treatment group at all follow-up visits (p<0.05). Seven months post-treatment, calcifications dissolved completely in 19% of the treatment group and 8% of the control group, and a >50% reduction was observed in 19% and 8% respectively. With regard to reduction of pain, there was significant improvement in the treatment group compared with the control group at the 1-week follow-up (p<0.05). However, at the 3-month and 7-month visits, no significant between-group difference in pain could be detected.

Conclusion

As applied, ESWT with an energy flux density of 0.28mJ/mm2 led to a significantly greater improvement in shoulder function and a slightly higher, nonsignificant, rate of > 50% disintegration of calcific deposits compared with the control group. However, this did not result in reduction of pain.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Universitätsklinik für Klinische Pharmakologie, Allgemeines Krankenhaus Wien, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Johannes Pleiner, Richard Crevenna, Mohammad Keilani, Martin Nuhr, Günther Wiesinger & Michael Quittan

  2. Department of Radiology (Osteology), Austria

    Herbert Langenberger & Franz Kainberger

  3. Department of Clinical Pharmacology, Medical University of Vienna, Austria

    Johannes Pleiner & Michael Wolzt

  4. Kaiser Franz Josef Spital, Vienna, Austria

    Michael Quittan

Authors
  1. Johannes Pleiner
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  2. Richard Crevenna
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  3. Herbert Langenberger
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  4. Mohammad Keilani
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  5. Martin Nuhr
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  6. Franz Kainberger
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  7. Michael Wolzt
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  8. Günther Wiesinger
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  9. Michael Quittan
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Correspondence to Johannes Pleiner.

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Pleiner, J., Crevenna, R., Langenberger, H. et al. Extracorporeal Shockwave treatment is effective in calcific tendonitis of the shoulder. A randomized controlled trial. Wien Klin Wochenschr 116, 536–541 (2004). https://doi.org/10.1007/BF03217707

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  • DOI: https://doi.org/10.1007/BF03217707

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