From the Guidelines
Yes, focal shockwave therapy can effectively break up tendon calcification, as supported by the evidence from the American Family Physician journal in 2005 1. The treatment involves delivering high-energy acoustic waves to the affected area, causing mechanical stress that fragments calcium deposits and stimulates healing.
- Key points to consider:
- Focal shockwave therapy is a non-invasive treatment option for chronic tendinopathies, including calcific tendinopathy.
- The therapy has been shown to be safe and effective in providing pain relief, with success rates ranging from 60-80% for calcific tendinopathy.
- Treatment typically involves 3-5 sessions spaced 1 week apart, with each session lasting about 10-15 minutes.
- The procedure uses either radial or focused shockwaves at intensities between 0.08-0.4 mJ/mm², adjusted based on patient tolerance.
- The evidence rating for extracorporeal shock wave therapy is B, indicating inconsistent or limited-quality, patient-oriented evidence, but it is still considered an effective option for pain relief in chronic tendinopathies 1.
- It is essential to note that while focal shockwave therapy can break up tendon calcification, it is crucial to consider the individual patient's condition, medical history, and other treatment options before making a decision.
- As stated in the evidence, surgery is an effective option in carefully selected patients who have failed three to six months of conservative therapy, including focal shockwave therapy 1.
From the Research
Focal Shockwave Therapy for Tendon Calcification
- Focal shockwave therapy has been studied as a treatment for tendon calcification, with varying degrees of success 2, 3, 4.
- A randomized controlled trial compared ultrasound-guided needling with high-energy extracorporeal shockwave therapy for calcific tendinitis of the rotator cuff, finding that both treatments improved function and pain, but ultrasound-guided needling was more effective in eliminating calcific deposits 2.
- A systematic review of shockwave therapies in soft tissue conditions found evidence for the benefit of focused extracorporeal shockwave therapy (F-ESWT) in the treatment of calcific tendinitis, with higher dose regimes showing greater success 3.
- A study on the clinical outcomes of combined focused shock wave and ultrasound-guided percutaneous irrigation of rotator cuff calcific tendinopathy therapy found a high resorption rate and improved clinical scores, with complete resorption occurring in 82.9% of shoulders 4.
Mechanism of Action
- Shockwave therapy is thought to stimulate bone turnover, osteoblast stimulation, and neovascularization by mechanotransduction, leading to the breakdown of calcific deposits 3, 5.
- The exact mechanism of action is not fully understood, but it is believed to involve the stimulation of cellular activity and the promotion of healing 6.
Efficacy and Safety
- The efficacy of focal shockwave therapy for tendon calcification is supported by several studies, with improvements in clinical scores and resorption rates reported 2, 3, 4.
- The safety of shockwave therapy has been established, with few adverse effects reported in the literature 3, 5.
- However, more research is needed to fully understand the effects of shockwave therapy on tendon calcification and to determine the optimal treatment parameters 6.