Shoulder function after extracorporal shock wave therapy for calcific tendinitis

We report a controlled, prospective study that explored the effect of extra corporal shock waves of low- versus high-energy density in patients with ch ronic shoulder pain and calcific tendinitis. We assigned at random 100 pati ents who had had calcific tendinitis for more than 12 months to 2 groups to receive shock wave therapy either of a low- or high-energy density Group I received 1500 impulses of 0.06 mJ/mm(2), whereas group 2 received 1500 imp ulses of 0.28 mJ/mm(2). Unlike group 1, in which the shock wave application could be performed without local anesthesia, all patients in group 2 requi red brachial plexus anesthesia. The patients were reviewed at 6 and 24 week s. Partial or complete disintegration of the calcareous deposit was observe d in 50% of the patients in group I and 64% of the patients in group 2 (P < .01). According to the Constant score, ratings increased from 48 to 71 poi nts in group 1 (P < .001) and from 53 to 88 in group 2 (P < .001) (out of a total possible 100 points), the end values of both groups differing signif icantly (P < .01). After 24 weeks, 52% of the patients in group I rated the results of treatment as good or excellent, compared with 68% in group 2 (P < .01). No improvement was reported by 24% versus 10% respectively, at the 24-week follow-vp.