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Radial Shockwave for calcified haematoma biceps

Hi there I am working in a Physiotherapy clinic that has recently got radial shockwave therapy . I have one particular patient who post biceps contusion 2 weeks ago has developed a calcified haematoma. The Dr recommended laser treatment for this. Due to close proximity to this clinic the patient decided to try shockwave instead. On assessment it appears his biceps is calcified. I am looking for advice on the best course of treatment for this patient and settings with regard to the shockwave treatment. Thanks

Niamh Keohane

2 weeks ago

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Prof Tim Watson
Prof Tim Watson

Niamh. Thanks for the query to the forum. I have just had a quick look on my database and have over 120 papers on shockwave in calcific tendinitis. The majority which evidence the 'reduction' of calcification volume etc are related to the use of focussed shockwave. There are a couple which have looked at radial shockwave, and I will paste the refs below in case they are helpful to you. I am sure that there are others, but this will get you started

The majority of these provide supportive evidence and the majority include some commentary re focussed vs radial shockwave

Avancini-Dobrovic, V., et al. (2011). "Radial extracorporeal shock wave therapy in the treatment of shoulder calcific tendinitis." Coll Antropol 35 Suppl 2(2): 221-225.

THIS PAPER IS AHEAD OF PRINT, BUT IS A USEFUL SYSTEMATIC REVIEW WHICH INCLUDES POSITIVE FINDINGS FOR RADIAL SHOCKWAVE: Wu, Y. C., et al. (2017). "Comparative effectiveness of non-operative treatments for chronic calcific tendinitis of the shoulder: A systematic review and network meta-analysis of randomized-controlled trials." Arch Phys Med Rehabil

Hawk, C., et al. (2017). "Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions." J Manipulative Physiol Ther 40(5): 293-319.

Kim, E. K. and K. I. Kwak (2016). "Effect of extracorporeal shock wave therapy on the shoulder joint functional status of patients with calcific tendinitis." J Phys Ther Sci 28(9): 2522-2524.

Carlisi, E., et al. (2016). "Focused extracorporeal shock wave therapy combined with supervised eccentric training for supraspinatus calcific tendinopathy." Eur J Phys Rehabil Med (ahead of print - just checked)

Moya, D., et al. (2015). "Current knowledge on evidence-based shockwave treatments for shoulder pathology." Int J Surg 24(Pt B): 171-178.

luisef258
luisef258

Hi Niamh I do not know of strong evidence that radial shock waves are related to the lysis of traumatic muscle calcifications. However, they may be an interesting technique in the improvement of pain symptoms and functional capacity. Thus, in my opinion, the use of weekly sessions (4 to 6 weeks) of 2000 shots with pressures between 2.5 and 4 bars can achieve the objectives I am referring to. Regards

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