Radial Shockwave Therapy for Calcific Tendinopathy with Superimposed Adhesive Capsulitis: A Case Report

Case Diagnosis: A 53-year-old male curler with calcific tendinopathy and superimposed adhesive capsulitis

Case Description or Program Description: This patient presented with 8-9 months of atraumatic right shoulder pain and decreased range of motion (ROM), initially diagnosed as calcific tendinopathy by an orthopedic clinician. Despite undergoing a subacromial steroid injection and physical therapy, his symptoms improved minimally. The patient continued to experience significant pain, decreased range of motion, and stiffness. Clinical evaluation and imaging, including X-ray, ultrasound, and MRI, revealed a large calcific deposit in the supraspinatus tendon, mild rotator cuff tendinosis, and thickening of the inferior glenohumeral ligament which is often associated with adhesive capsulitis.

Setting: Outpatient orthopedic and rehabilitation center

Assessment/Results: The patient underwent six weekly sessions of radial shockwave therapy targeting the shoulder capsule and surrounding musculature. At 6-week follow-up, he reported 80% improvement in ROM and 90% improvement in pain. At 6 months, his ROM was restored by 90%, with minimal pain at end range, resulting in a significant improvement in both function and quality of life.

Discussion (relevance): Calcific tendinopathy of the rotator cuff is a common condition, typically presenting with pain and decreased mobility. Adhesive capsulitis, frequently seen in conjunction with rotator cuff pathology, further limits ROM, causing debility for many patients. The failure of traditional interventions such as steroid injections and physical therapy prompted the use of radial shockwave therapy, which led to significant improvements in pain and ROM following six treatments over the course of six weeks. Notably, these improvements were sustained at the 6-month follow-up, highlighting the potential lasting benefits of this therapy.

Conclusions: This case demonstrates radial shockwave therapy as an effective modality in managing resistant calcific tendinopathy and adhesive capsulitis.