Comparison of the effects of ultrasound- guided needle puncture,radial shock wave therapy,and combined treatments on calcific tendinitis of the shoulder: A single-blind randomized controlled trial

Abstract

BACKGROUND:

Calcific tendinitis of the shoulder is a common disorder resulting in restricted motion and pain.

OBJECTIVE:

This study compared the effects of ultrasound-guided fine-needle puncture (USNP), radial shock wave therapy (RSWT), and the combination of both treatments (COMB) on calcific tendinitis of the shoulder.

METHODS:

We enrolled 62 patients who had unilateral shoulder pain for more than 3 months. The patients were randomly divided into three groups: USNP, RSWT, and COMB. All USNP needle punctures were guided with ultrasound (US), and RSWT was delivered at 2 Hz (2000 shock waves; 0.26 mJ/mm ${}^2$ ) once a week for 3 weeks. The COMB group received three weekly rounds of RSWT after a single US-guided needle puncture. The primary outcome was the pain visual analog scale (VAS), and secondary outcomes were the Constant scores, 36-Item Short-Form Health Survey, and range of motion.

RESULTS:

A within-group comparison at 3 months revealed significant improvements in the pain VAS ( $p<$ 0.05, during activity) and Constant ( $p<$ 0.05) scores, but between-group comparisons revealed no statistically significant differences in the pain VAS ( $p>$ 0.05) or Constant ( $p=$ 0.089) scores. Only improvement differences in role-emotional (SF-36; $p=$ 0.01) and active external rotation ( $p=$ 0.035) were determined over time, which favored the USNP and COMB groups.

CONCLUSIONS:

Although no significant differences were observed among the groups in the treatment of calcific tendinitis of the shoulder, more satisfactory outcomes were noted in the USNP and COMB groups than in the RSWT group. Larger samples, longer follow-up times, and other treatment protocols are suggested for future studies.