Can shock wave therapy be effective in the treatment of rotator cuff disease with or without calcification?

Shoulder disorders are common, with a prevalence ranging from 7% to 26% in adults. The most common cause of shoulder pain seen by physicians is rotator cuff disease, and it is estimated to occur in up to 50% of people over 75 years old.

The objectives of the treatment are to relieve pain and restore shoulder movement and function. There are different conservative treatments commonly used, including oral analgesics, corticosteroid injections, or shock wave therapy. Despite the widespread use of shock wave therapy, evidence of its effectiveness is equivocal, therefore Surace and colleagues conducted this review in order to determine the benefits and harms of shock wave therapy for rotator cuff disease, with or without calcification.

Thirty-two trials including 2,281 participants were eligible, 25 of which included patients with rotator cuff disease and calcific deposits, five included patients with rotator cuff disease and no calcific deposits and two with a mixed trial without calcific deposits. There was a wide heterogenicity of trial design, and all were susceptible to biases of selection and performance reporting. Pain relief over 30% was not reported by any trial, except from one trial at three months follow-up. Adverse events did not differ between the treatment or placebo groups. 

Nevertheless, based on the low to moderate evidence, the authors recommend conducting higher quality trials.

Commented by Sara Laxe