Shock Wave Therapy Helps Ailing Shoulders

By Jessica Ross for Shoulder1
A German team of researchers, led by Dr. Ludger Gerdesmeyer, has recently published findings indicating that shock wave therapy can help alleviate chronic calcifying tendonitis of the shoulder joint. Writes Gerdesmeyer, "[b]oth high-energy and low-energy ESWT (extracorporeal shock wave therapy) appeared to provide a beneficial effect on shoulder function, as well as on self-rated pain and diminished size of calcifications, compared with placebo." The work by the German group joins a growing body of evidence supporting the use of shock wave therapy as a means to eradicate the crystalline calcium phosphate deposits associated with this disease. Calcifying tendonitis of the shoulder is a disease characterized by the accumulation of crystalline calcium phosphate deposits around the tendons of the rotator cuff. The rotator cuff is the system of muscles and tendons connecting the arm to the shoulder joint and controls arm motion. Naturally, the introduction of a physical obstruction into this area can easily disrupt the normal mechanics of arm and shoulder function. In the case of calcifying tendonitis, there is often incidence of mild pain with occasional flare-ups, mechanical problems, or severe acute pain. Elevation of the arm can cause aggravation, and stiffness, snapping, catching, or weakness is also often reported. Calcifying tendonitis is most often reported between 30 – 50 years of age, and can be detected via X-ray or MRI. Gerdesmeyer and colleagues set out to determine if the use of ESWT yielded increased shoulder function, reduced pain and decreased the size of calcification deposits in patients with chronic calcifying tendonitis. Their evaluation included 144 patients who were administered two treatments of high-energy shock wave therapy (SWT), low-energy SWT, or a placebo during a two-week period, followed by physical therapy. Both the high-energy and low-energy groups demonstrated improved shoulder function, with the high-energy patients experiencing the largest degree of improvement. Significantly, follow-up visits indicated a continuing improvement in pain and reduction of calcified deposits, particularly in the high-energy group. Aside from temporary bruising, the team also reported very few side effects from the treatment. The results from the Gerdesmeyer team join evidence accumulated from several other studies indicating a role for ESWT in alleviating calcifying tendonitis of the shoulder. Earlier in 2003, Wang et al published a study in the American Journal of Sports Medicine that followed 37 patients who had received SWT treatment for calcified tendonitis of the shoulder. The results of SWT as reported by the patients after 2 or more years were largely successful: 60.6% indicated "excellent" results, while 30.3% described their status as "good." Also significantly, the dissolution of the calcified deposits was complete in 57.6%, or at least partial in 15.1%. There was no recurrence of calcified deposits at the two-year mark, and this noninvasive treatment was deemed overall both safe and effective. Several other studies have yielded similar results to those presented by Gerdesmeyer and Wang. Significantly, research also seems to indicate that shock wave therapy creates no initial complications or significant negative impact on the anatomy of the shoulder, creating high hopes for SWT as a safe, effective, noninvasive treatment method for calcified tendonitis.

Last updated: 11-Feb-04