Evaluating ESWT Effects in Treating Calcified Rotator Cuff Tendinopathy

June 30, 2022  |  By Elise Hamann

Evaluating ESWT Effects in Treating Calcified Rotator Cuff TendinopathyIt’s more important than ever to stay abreast of the most current research findings related to Extracorporeal Shockwave Therapy. 

A recent research study was designed to evaluate the effects of high-energy shockwave therapy on outcomes (both objective and subjective) among participants with calcified rotator cuff tendinopathy. This parallel-group, randomized trial consists of two groups of 21 patients (42 in all) diagnosed with calcific RC tendinopathies. 


For full details, explore the research article published in Hindawi BioMed Research International titled “Effects of High-Energy Extracorporeal Shockwave Therapy on Pain, Functional Disability, Quality of Life, and Ultrasonographic Changes in Patients with Calcified Rotator Cuff Tendinopathy.” 


What is Calcified Rotator Cuff Tendinopathy?

Among musculoskeletal disorders, shoulder pain is prevalent, and rotator cuff injury is a common cause of the pain.

In calcified rotator cuff tendinopathy, hydroxyapatite crystals deposit in rotator cuff tendons (most commonly the supraspinatus tendons and infraspinatus tendons). The prevalence of rotator cuff calcific deposits appears to be asymptomatic in adults approximately 8% of the time. But in nearly 43% of cases, the presence of subacromial pain syndrome (SAPS) is present.

Ultrasound and MRI are instrumental in diagnosing rotator cuff disorders.

Treatment Options for Calcified Rotator Cuff Tendinopathy 

When calcification of the rotator cuff occurs, an array of conventional and alternative treatment options are available to consider:

  • Physical therapy
  • Acupuncture
  • Massage therapy
  • Electrotherapeutic agents
  • Corticosteroid injections
  • Extracorporeal Shockwave Therapy (ESWT)

In physical therapy, eccentric loading training enhances better outcomes in alleviating pain and improving functional impairments in patients with rotator cuff tendinopathy.

Extracorporeal Shockwave Therapy (ESWT) is an effective treatment for calcific rotator cuff tendinopathy. Shockwave brings about an analgesic and anti-inflammatory response and facilitates tissue regeneration.

Defining the Interventional Groups

This prospective parallel, randomized controlled trial was conducted from April 2020 to June 2021, and participants diagnosed with calcific rotator cuff tendinopathies were asked to participate.

Participants were divided into two treatment groups: Extracorporeal Shockwave Therapy plus routine physiotherapy group (RPT); and routine physiotherapy group (RPT) – see the breakdown below.

Interventional Protocol by Group

ESWT+RPT Group RPT Group

(I) Stretching exercises

  • Shoulder external rotation stretch
  • Cross-body posterior stretch
  • Stretch for the anterior aspect of the shoulder
  • Shoulder flexion stretch

(I) Stretching exercises

  • Shoulder external rotation stretch
  • Cross-body posterior stretch
  • Stretch for the anterior aspect of the shoulder
  • Shoulder flexion stretch

(II) Strengthening exercises

  • Chair press
  • Restricted scapular retraction
  • Restricted scapular protraction
  • Shoulder abduction “scaption” (0°-90°) with TheraBand
  • Shoulder scapular extension with TheraBand

(II) Strengthening exercises

  • Chair press
  • Restricted scapular retraction
  • Restricted scapular protraction
  • Shoulder abduction “scaption” (0°-90°) with TheraBand
  • Shoulder scapular extension with TheraBand

(III) Shockwave treatment

  • Treatment protocols were administered to the patients in both experimental [RPT + ESWT] and routine physiotherapy {RPT] groups in 12 sessions over the course of six weeks, with two sessions per week.
 


Outcome Measures 

Both groups in the study experienced a significant reduction in the numeric pain rating score (NPRS) and the size of calcific deposits and an improvement in Constant and Murley scores, as well as notable improvements in quality of life. Pain levels and functional outcomes showed remarkable improvement in both at follow-ups post-treatment.

Compared to the RPT-only group, the most favorable outcomes were visible on ultrasound in relation to treatment with the ESWT.

Outcomes Favor ESWT and Long-Term Positive Results

Extracorporeal Shockwave Therapy is proven effective as a treatment option for the management of calcified rotator cuff tendinopathy. The study outcomes confirm its role in improving pain, functionality, mobility, quality of life, and measurably decreasing the size of the calcified deposits.

This gives patients a new lease on life, and they can look forward to re-engaging in daily life activities without pain. ESWT is a safe, non-invasive, cost-effective intervention shown to reduce disability often associated with this condition.

While RPT has long been utilized as an effective treatment in rotator cuff tendinopathy, this study proves shockwave therapy is superior to it, which is especially visible at long-term follow-up. Because ESWT facilitates tissue regeneration, it can make differences not possible with RPT alone.

Adding Shockwave to Your Continuum of Care Can Be Game-Changing 

As the evidence is mounting on the clear clinical benefits of treating patients with life-changing innovative treatments like shockwave and EMTT, perhaps it’s time to consider what investing in these technologies could mean to your practice and your patients.

ESWT has been extensively used to manage musculoskeletal disorders like unhealed fractures, plantar fasciitis, lateral epicondylitis, and heel pain, to name a few. Adding the right technologies can draw in new patients seeking the treatment by name. And happy patients will gladly give testimony and praise for treatments that address painful, debilitating conditions.  

Time and again, we hear from medical professionals who have revolutionized their practice by adding regenerative technologies such as ESWT, EPAT, and EMTT. If you’ve not yet viewed this educational Webinar, Treating From Head to Toe Using Shockwave, EMTT and More,  now’s the time as it has been a favorite among medical professionals. You’ll be inspired by Dr. David Cunningham’s insights and mastery, which can help you conceptualize the power of EPAT, ESWT, EMTT – and implement these modalities into your practice for clinical and business success. 

Have questions about EPAT/ESWT/EMTT and wonder what the impact of adding these technologies to your continuum of care might look like? We’re here to answer any questions and will gladly connect you with one of our team experts — Contact us today!
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Topics: Research, ESWT