Calcifying Tendonitis of the Shoulder: Risk Factors and Effectiveness ofPhysical Therapy

Abstract

The aim of this study is to determine the different risk factors associated with Calcifying tendonitis (CT), to characterize it epidemiological-clinical-radiological, in a number of cases, and to assess the effect of physical therapy in improving mobility and decreasing pain. A prospective experimental intervention to a series of 50 patients (40 experimental group and 10 control group) diagnosed of CT referred to the Rehabilitation Department of the University Welfare Complex of Salamanca was performed, during October 2011 to February 2013. In the initial assessment the demographics, personal history, predisposing factors and type of calcification (formative/resorptive), were collected. The evaluation of the shoulder Range of Movement (initial ROM) was performed. Pain was valued according to visual analog scale (initial VAS). The intervention consisted in prescribing Kinesiotherapy (KT) (if restricted mobility) or various electrotherapy modalities (US ultrasound, TENS, Microwave MW, Shortwave SW, Interferential IF) (if pain). In the final evaluation mobility (final ROM) and pain (final VAS) was re-evaluated, in addition to the global patient satisfaction. CT is more common in women (n=36; 72%) than in men (n=14; 28%) (p=0.00). The CT occurs in middle age/working life (53.96 years, SD=±11.99). The most common occupation were housekeeper and assistant. They presented forced postures, repetitive movements and cargo handling. CT prevailed in right shoulders (n=33; 66%), in the SE tendon (n=46; 92%) and all patients had radiological, ultrasound (n=24; 48%) and MRI (n=8; 16%) evaluation. Most patients had formative (n=38; 76%) rather than resorptive calcifications (n=12; 24%) (p=0.00). The average number of rehabilitation sessions was 28.6 ± 12.9 days. VAS diminished from 5.96 to 3.26 points after kinesiotherapy/electrotherapy treatment. KT treatment recovers ROM significantly (p<0.05). Resorptive calcifications had more chronic pain. The treatment group decreased VAS significantly (p=0.00) from 5.47 to 2.28 points, while the control group diminished VAS not significantly from 6.92 to 5.75 (p=0.06). The significant risk factors for developing CT are female, Caucasian, middle-age/working-life, with repetitive manual movements or forced positions, right SE tendon, formative calcification. Kinesiotherapy improves mobility and electrotherapy reduces pain significantly in the experimental group