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New alternative to surgery for shoulder pain?

One of the most common causes of shoulder pain — rotator cuff tendinitis — may soon be treatable with an alternative to surgery and over-the-counter painkillers: shock wave therapy. Tufts Medical Center researchers reviewed 28 clinical trials evaluating the efficacy of the therapy, which can be performed in a doctor’s office, and found that it was effective for a specific form of the condition — usually caused by muscle strain from heavy lifting — where calcifications were present on an imaging scan of the tendons.

The researchers also found that high-energy shock therapy worked better than the low-energy method, according to the results published Monday in the Annals of Internal Medicine.

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“It’s a promising treatment for this form of shoulder pain,” said study leader Dr. Raveendhara Bannuru, a primary care physician at Tufts. Side effects from the treatment were mild: redness and soreness at the treatment site that disappeared within a few days. “It’s a pretty simple procedure without any significant side effects like those caused by chronically using nonsteroidal anti-inflammatory painkillers, which can cause stomach ulcers and heart problems.”

But don’t look for it in the doctor’s office just yet: It’s not approved by the US Food and Drug Administration for this purpose, though it’s currently used to treat other inflammatory conditions such as tennis elbow and foot pain due to plantar fasciitis.

Also, researchers still don’t have a full understanding of how shock waves work, whether they permanently alter muscle in a possibly negative way, and how long the effects of the therapy last.

“Most of the studies we looked at were conducted in Europe where it’s more widely available,” Bannuru said. “Hopefully, we’ll have clinical trials soon in this country.”

Deborah Kotz can be reached at Follow her on Twitter @debkotz2.
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