This protocol applies to patients with shoulder calcific tendinopathy whose pain has persisted and shoulder range of motion has not been adequately restored despite a prior course of conservative management.
The preceding line of management consists of conservative treatment, which may include non-steroidal anti-inflammatory analgesics with arm sling and passive range-of-motion exercises, subacromial corticosteroid injection, ultrasound-guided barbotage, ultrasound therapy, or extracorporeal shock wave therapy (ESWT).
Escalation to this protocol is indicated when that conservative approach has not achieved the expected goals: resolution of shoulder pain and restoration of shoulder range of motion.
DOI: 10.5397/cise.2020.00318
For patients who do not respond to conservative treatment after 6 months, surgery should be considered.
However, chronic calcific tendinitis often requires surgical treatment, which can take the form of open surgery or arthroscopic surgery.
Both surgical methods remove calcific deposits and have shown satisfactory clinical outcomes.
Other studies reported that patients whose radiographic findings after surgery indicated a removal or reduction of calcific deposits showed better prognoses than those whose calcific deposits remained unchanged.
However, the clinical symptoms of many patients do not improve immediately after surgery and require 6 months or more for complete recovery.
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