A controlled prospective randomized study was designed to analyze the effect of
extracorporeal shock wave therapy on calcifying
tendinopathy of the shoulder focused on the calcified area or the origin of the supraspinatus tendon. Fifty patients were included in the study and were treated with a Storz Minilith
Sl-1 shock wave generator. The first group of patients received 4000 impulses (positive energy flux density, 0.78 mJ/mm2) in two treatment sessions after receiving
local anesthesia at the origin of the supraspinatus tendon. Patients in the second group received
extracorporeal shock wave therapy at the calcified area. Follow-ups were done 12 weeks and 1 year
after treatment by an independent observer. An increase of function and a reduction of
pain occurred in both groups. Statistical analyses showed a significant superiority of extracorporeal
shock wave application at the calcified area in the primary end point (Constant and Murley score). Therefore, exact fluoroscopic focusing of
extracorporeal shock wave therapy at the calcific deposit for treatment of calcifying
tendinopathy of the supraspinatus muscle is recommended. Based on these results, extracorporeal
shock wave application should be focused fluoroscopically with appropriate
shock wave generators.