Comparison of Extracorporeal Shock Wave Therapy and Ultrasound-Guided Shoulder Injection Therapy in Patients with Supraspinatus Tendinitis

Abstract

Background The present study compared the clinical effect of extracorporeal shock wave therapy (ESWT) with that of ultrasound (US)-guided shoulder steroid injection therapy in patients with supraspinatus tendinitis. We hypothesized that the two treatments would show comparable results. Methods The inclusion criteria were age over 20 years and diagnosis of supraspinatus tendinitis using US. Ultimately, 26 patients were assigned using blocked randomization: 13 in the US-guided shoulder injection group and 13 in the ESWT group. Treatment outcomes were evaluated using the pain visual analog scale (pVAS), the American Shoulder and Elbow Society (ASES) score, and the Constant score at baseline and at 1 and 3 months after the procedure. Results At 1 month after the intervention, pVAS, ASES, and constant score were significantly higher in the US-guided shoulder injection group than in the ESWT group, but not at 3 months after the intervention. Both groups showed clinically significant treatment effects at 3 months after the intervention compared to baseline. No significance was shown using equivalence testing. Conclusions US-guided shoulder injection therapy was not superior to ESWT therapy. Considering the complications and rebound phenomenon of steroid injections, interventions using ESWT may be a good alternative to treat patients with supraspinatus tendinitis.

Extracorporeal shock-wave therapy for the treatment of non-calcific rotator cuff tendinopathy: A systematic review and meta-analysis

“…All individuals presented chronic symptoms (greater than 3 mos) and one study did not report the duration of symptoms. 19…”

“…15,18 Other treatment protocols were five sessions of ESWT with an interval of 3 days, 7 three sessions with an interval of 10-14 days, 17 and three sessions with monthly intervals. 21 Six studies used medium-energy dose (0.08-0.28 mJ/ mm 2 ), 7,15,17,[19][20][21] and two studies used high-energy dose (>0.28 mJ/mm 2 ). 14,18,22 The effects of ESWT were compared with sham ESWT, 7,14,16,17,20,21 supervised exercises, 18 and hyaluronic acid injection.…”

“…14,18,22 The effects of ESWT were compared with sham ESWT, 7,14,16,17,20,21 supervised exercises, 18 and hyaluronic acid injection. 15 One study 19 applied linear focused ESWT, three radial ESWT, 7,18,23 and five did not describe the type of ESWT. [14][15][16]20,24…”

“…15 The Constant-Murley score was used to assess pain intensity and shoulder function. 7,[15][16][17]19,20…”

“…Extracorporeal shockwave therapy was superior to sham ESWT ( P = 0.04, SMD = −0.28, 95% CI, −0.55 to −0.01) in improving pain intensity at short-term follow-up, based on moderate-certainty evidence (Appendix 1, http://links.lww.com/PHM/C218). A sensitivity analysis with two studies 17,19 indicated that radial One study 14 with a sample size of 29 individuals compared the effects of ESWT to sham ESWT on pain intensity at long-term follow-up (Fig. 2C).…”