Shockwave Therapy for Calcific Tendinopathy/Tendinitis

Understanding Calcific Tendinopathy/Tendinitis

What is Calcific Tendinopathy/Tendinitis?

Calcific tendinopathy, also known as calcific tendinitis, is a condition characterised by the formation of calcium deposits within a tendon, most commonly affecting the rotator cuff tendons of the shoulder. These deposits can cause pain, inflammation, and reduced mobility in the affected joint. Calcific tendinopathy is more prevalent in adults between the ages of 30 and 50, and it can significantly impact daily activities and quality of life.

Causes and Risk Factors

The exact cause of calcific tendinopathy is not fully understood, but several factors may contribute to the development of this condition:

• Overuse or repetitive strain on the affected tendon
• Aging and degenerative changes in the tendon
• Decreased blood supply to the tendon
• Hormonal imbalances, such as thyroid disorders or estrogen deficiency
• Genetic predisposition
• Metabolic disorders, such as diabetes

Shockwave Therapy for Calcific Tendinopathy/Tendinitis

What is Shockwave Therapy?

Shockwave therapy, also known as extracorporeal shockwave therapy (ESWT), is a non-invasive treatment that uses high-energy sound waves to break up calcium deposits and stimulate healing in the affected tendon. The shockwaves are generated by a handheld device and applied to the skin over the affected area, targeting the calcific deposits within the tendon.

How Does Shockwave Therapy Work?

Shockwave therapy promotes healing and pain relief through several mechanisms:

• Breaking up calcific deposits: The high-energy shockwaves can physically break apart the calcium deposits within the tendon, making them smaller and easier for the body to absorb and eliminate.
• Stimulating blood flow: Shockwaves can increase blood circulation in the treated area, bringing oxygen and nutrients to the damaged tendon and promoting healing.
• Activating cellular processes: The mechanical stimulation provided by shockwaves can trigger the release of growth factors and other biochemicals that promote tissue repair and regeneration.
• Reducing pain and inflammation: Shockwave therapy can modulate nerve impulses and decrease sensitivity, leading to pain relief and reduced inflammation in the affected tendon.

The Shockwave Therapy Procedure

Shockwave therapy for calcific tendinopathy is performed as an outpatient procedure, typically taking 15-30 minutes per session. The process involves the following steps:

1. The patient is positioned comfortably, with the affected area exposed
2. A gel is applied to the skin to facilitate shockwave transmission
3. The physiotherapist positions the handheld device on the skin and delivers the shockwaves to the targeted area
4. Some discomfort or pain may be experienced during the procedure, but this is generally well-tolerated
5. After the session, the patient can usually return to normal activities, although temporary soreness or swelling may occur

Treatment Protocol and Expected Outcomes

The number of shockwave therapy sessions needed for calcific tendinopathy varies depending on the size and location of the calcific deposits, as well as the individual’s response to treatment. A typical treatment protocol may include:

• 3-6 sessions, scheduled at weekly intervals
• Progressive improvement in symptoms over the course of treatment
• Follow-up imaging to assess the reduction in calcific deposits
• Continuation of a rehabilitation programme to restore strength and mobility in the affected joint

Studies have shown that shockwave therapy can be a highly effective treatment option for calcific tendinopathy, with success rates ranging from 60-90%. Many patients experience significant reductions in pain, improved mobility, and gradual resorption of the calcific deposits following treatment.

Complementary Treatments and Prevention Strategies

Combining Shockwave Therapy with Other Treatment Modalities

While shockwave therapy can be a powerful tool in managing calcific tendinopathy, it is often most effective when combined with other treatment modalities, such as:

• Physical therapy to address muscle imbalances, improve flexibility, and restore joint function
• Nonsteroidal anti-inflammatory drugs (NSAIDs) or ice therapy to manage pain and inflammation
• Gradual return to activity, with modifications as needed to prevent further injury
• In some cases, ultrasound-guided needle aspiration or surgery may be necessary for large or resistant calcific deposits

Preventing Calcific Tendinopathy/Tendinitis

While some risk factors for calcific tendinopathy, such as age and genetics, cannot be modified, several strategies may help reduce the risk of developing this condition:

• Maintain flexibility and strength in the muscles surrounding the affected joint through regular stretching and exercise
• Gradually increase training intensity and duration, allowing the body time to adapt
• Use proper form and technique during activities that put stress on the tendons, such as overhead movements or repetitive motions
• Take breaks and allow for adequate rest and recovery between activities
• Address any underlying health conditions that may contribute to the development of calcific tendinopathy, such as thyroid disorders or diabetes

At MSKClinic, we offer shockwave therapy as part of our comprehensive approach to treating calcific tendinopathy and other musculoskeletal conditions. Our experienced physiotherapists work closely with each patient to develop a personalised treatment plan that incorporates the latest evidence-based techniques and a strong focus on patient education and empowerment. If you are experiencing symptoms of calcific tendinopathy, contact us today to learn more about how shockwave therapy and our other services can help you find relief and get back to the activities you love.