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Treatment Dissolves Calcifications, Could Replace Surgery in Some Patients

Nov. 20, 2003 -- A new treatment for chronic shoulder pain is showing promise. A new study shows that an ultrasound treatment called "extracorporeal shock wave therapy" can be effective in helping a painful rotator cuff.

The study appears in this week's issue of TheJournal of the American Medical Association.

Extracorporeal shock wave therapy involves either applying high-energy or low-energy shock waves to the painful area -- in this case, the rotator cuff.

Specifically, the researchers were testing the ability of the ultrasound treatment to treat calcific tendinitis of the rotator cuff, a common cause of shoulder pain. In this condition, calcium deposits build up on the tendons that connect rotator cuff muscles to the nearby bones.

The shock wave treatment has been shown in other studies to help destroy other types of calcified deposits and could be an alternative to surgery, writes lead researcher Ludger Gerdesmeyer, MD, with Orthopedic Surgery and Sportstraumology at Technical University Munich in Germany.

In their study, researchers treated patients with either high-energy or low-energy shock waves. For comparison, some patients received a placebo treatment during which the same procedure was performed but no shock waves were delivered. All 134 patients had shoulder pain caused by calcific tendinitis of the rotator cuff. The participants received two treatments, each two weeks apart.

Three, six, and 12 months later, the high-energy and low-energy patients all had significant rotator cuff improvement in various areas -- pain reduction, activities of daily living, range of motion, and power -- compared with the placebo group.

Those receiving the placebo treatment also showed improvement, but they required more medication and were more likely to need surgery than patients that received either dose of the shock wave therapy.

The group getting high-energy therapy to the rotator cuff got significantly better results than the low-energy group.

The researchers suggest that if further studies duplicate the beneficial results seen in this study, treatment with shock wave therapy could one day replace surgery in some patients.

SOURCE: Gerdesmeyer, L. TheJournal of the American Medical Association, Nov. 19, 2003; vol 290: pp 2573-2580.

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