A conservative management protocol for calcific tendinitis of the shoulder

OBJECTIVE: This paper presents a management protocol for calcific tendinitis and describes its effective application in 2 cases of calcific tendinitis of the supraspinatus tendon in middle-aged women. CLINICAL FEATURES: Two patients presented to a chiropractic clinic with previously diagnosed calcific tendinitis of the supraspinatus tendon. Both patients complained of chronic pain and tenderness in the shoulder region and had a limited range of shoulder motion as a result of the pain. Radiographs demonstrated calcific deposits in the region of the supraspinatus tendon. INTERVENTION AND OUTCOMES: Both patients were admitted to a treatment protocol involving approximately 20 sessions of phonophoresis (driving of medication into tissue by ultrasound) with Movelat cream followed by cross-friction massage to the supraspinatus tendon and range of motion exercises. A second set of radiographs was requested. The calcific deposits, clearly seen on the previous radiographs, were no longer visible, and symptoms were resolved. At 4-month follow up, both patients continued to be symptom-free. CONCLUSION: The result of these studies indicates that the management of calcific tendinitis falls within the scope of chiropractic practice and supports the use of a trial period of conservative management in cases of calcific tendinitis before consideration of surgical treatment.