Treatment of Subacromial Bursitis with Tendinosis Calcarea and Calcium Deposits in Subacromial Tendons
Subacromial bursitis presenting alongside tendinosis calcarea — where calcium deposits are confirmed in the subacromial tendons — represents a clinically distinct scenario requiring a targeted management approach.
This protocol is specific to patients with subacromial bursitis in the context of tendinosis calcarea with calcium deposits in the subacromial tendons. The presence of calcium deposition is a key factor: evidence indicates that treatments showing benefit in this calcific setting do not necessarily perform the same way in patients without calcium deposits.
First-line management centres on a period of relative rest during the acute phase, with an oral anti-inflammatory agent as part of the initial plan. The complete structured regimen — including the full sequence of steps and all relevant considerations — is available in the protocol below.
The primary clinical target is meaningful reduction in shoulder pain within the first one to two weeks of treatment.
References
DOI: 10.3109/17453674.2014.920991
- High-energy extracorporeal shockwave therapy (ESWT) is more effective than low-energy ESWT or placebo in reducing pain and improving shoulder function in patients with tendinosis calcarea.
- ESWT (all forms) is no more effective than placebo or other treatments in reducing pain or in improving shoulder function of patients without calcium deposition in the tendons.
- A non-operative treatment algorithm for SAPS starts with a recommendation of relative rest in the acute phase, if necessary combined with a prescription of NSAIDs for 1 or 2 weeks.
- Oral NSAIDs appear to be more effective than placebo in reducing pain in the first 1–2 weeks.