Radial extracorporeal shock-wave therapy in patients with chronic rotator cuff tendinitis


Radial extracorporeal shock-wave therapy in patients with chronic rotator cuff tendinitis

A prospective randomised double-blind placebo-controlled multicentre trial

  1. H. van der Hoeven, MD, Orthopaedic Surgeon3
+Author Affiliations

  1. 1Rijnland Ziekenhuis Leiderdorp, Simon Smitweg 1, 2350 CC Leiderdorp, the Netherlands.

  2. 2St. Antonius Ziekenhuis, Nieuwegein, Koekoekslaan 1, 3435 CM Nieuwegein, the Netherlands.

  3. 3Bergman Clinics, Rijksweg 69, 1411 GE Naarden, the Netherlands.
  1. Correspondence should be sent to Mr H. van der Hoeven; e-mail:H.vanderhoeven@bergmanclinics.nl


The aim of this study was to determine the effect of radial extracorporeal shock-wave therapy (rESWT) on patients with chronic tendinitis of the rotator cuff. This was a randomised controlled trial in which 82 patients (mean age 47 years (24 to 67)) with chronic tendinitis diagnosed clinically were randomly allocated to a treatment group who received low-dose rESWT (three sessions at an interval 10 to 14 days, 2000 pulses, 0.11 mJ/mm2, 8 Hz) or to a placebo group, with a follow-up of six months. The patients and the treating orthopaedic surgeon, who were both blinded to the treatment, evaluated the results. A total of 44 patients were allocated to the rESWT group and 38 patients to the placebo group. A visual analogue scale (VAS) score for pain, a Constant–Murley (CMS) score and a simple shoulder test (SST) score significantly improved in both groups at three and six months compared with baseline (all p ≤ 0.012). The mean VAS was similar in both groups at three (p = 0.43) and six months (p = 0.262). Also, the mean CMS and SST scores were similar in both groups at six months (p = 0.815 and p = 0.834, respectively).
It would thus seem that low-dose rESWT does not reduce pain or improve function in patients chronic rotator cuff tendinitis compared with placebo treatment.
Cite this article: Bone Joint J 2013;95-B:1521–6.


  • The authors would like to thank P. Visser (Visser Physiotherapy) and R. van Cingel (Sport medical Centre Papendal) for participation and support during this trial. This study is supported by Electro Medical Systems (EMS).
    Although none of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article, benefits have been or will be received but will be directed solely to a research fund, foundation, educational institution, or other non-profit organisation with which one or more of the authors are associated.
    This article was primary edited by P. Baird and first-proof edited by J. Scott.
  • Supplementary material. A table showing the intention-to-treat results for all patients and by presence or absence of calcifications is available with the electronic version of this article on our website www.bjj.boneandjoint.org.uk
  • Received February 18, 2013.
  • Accepted July 9, 2013.
  • ©2013 The British Editorial Society of Bone & Joint Surgery