Calcific Tendonitis - ultrasound can help
Calcific tendonitis of the
shoulder causes pain that is not activity dependent and often severe.
Calcium deposits around the shoulder most commonly develop in the
supraspinatus tendon, but can also commonly occur in the bicep tendon.
The condition typically occurs in persons between the age of 30 and 50
but a literature search revealed no data on its incidence or on its
frequency relative to other causes of shoulder pain.
Patients who have calcific
tendonitis of the shoulder who are treated with ultrasound show better
short term and long term resolution of calcification and greater short
term symptom improvement than those who are not treated, according to a
randomized double blind study.
The 54 patients (61
shoulders) had calcific tendinitis confirmed by x-rays. The
treatment group (32 shoulders) had 24 ultrasound treatments,
5 per week for 3 weeks and 3 per week for 3 weeks after that. Controls
(29 shoulders) followed a similar schedule of sham ultrasound
treatments. Group assignment was by shoulders rather than by patients,
so patients with tendonitis in both shoulders could receive either
treatment or both.
A comparison of each patient's
baseline and post treatment shoulder xrays showed that calcium deposits
had resolved in six shoulders in the treatment group and had improved
(decreased by at least 50%) in nine; corresponding figures for controls
were zero and three. A comparison of each patient's baseline
and 9 month follow up radiographs revealed calcification had resolved
in 13 (42%) shoulders in the treatment group vs. 2 (8%) in controls;
improvement occurred in 7 (23%) treatment shoulders and 3 (12%) control
shoulders.
Clinical assessments included
three measures of pain, range of motion, shoulder strength, ability to
perform routine tasks, and quality of life. At the end of
therapy, the treatment group had significantly greater
decreases in pain and improvements in quality of life than controls. At
9 months, improvements persisted in both groups, but inter group
differences were no longer significant.
This study shows that
ultrasound is an extremely safe, non-invasive modality that may greatly
benefit those with calcific tendonitis.
Ebenbichler GR, Erdogmus CB,
Resch KL, et al; Ultrasound therapy for calcific tendinitis of the
shoulder. N Engl J Med 1999;340(20):1533-1538.
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