Treatment for Symptomatic Calcific Tendinopathy of the Shoulder. Ultrasound-Guided Needling Lavage and Extracorporeal Shock Wave Therapy vs Extracorporeal Shock Wave Therapy. A prospective observational study

Objective. To compare combined treatment ultrasound guided needling (UGL) and extracorporeal shockwave therapy (ESWT) versus ESWT alone in symptomatic calcific tendinopathy of supraspinatus. Methods. It is a prospective observational study. The participants were 50 consecutive patients with painful (NRS > 5) calcific tendinitis of the shoulder. Clinical and radiological data were collected before treatment (T0) at one (T1) and three months (T2) follow-up. Eligible patients were assigned to the Intervention Group (IG) with combined treatment and 3 sessions of focused ESWT (23 patients). Patients not willing to undergo UGL were considered as the Control Group (CG) and treated with 3 sessions of ESWT alone (27 patients). 36 patients reached T2. Results. Combined treatment was more effective in NRS reduction at one (T1) month follow up (p < 0.001). Moreover, in IG, it was observed a statistically significant difference in NRS (p < 0.001) and in the CMS (p < 0.001) at three months follow-up (T2). Calcific deposit was eradicated more effectively by combined treatment, with total resorption in 79 % at T2 (p < 0.001). Conclusions. Combined treatment ultrasound-guided needling lavage and shockwave therapy is a rapid, safe and effective treatment in patients with painful calcific tendinopathy, in pain reduction at one month follow-up.