Introduction: Calcific rotator cuff tendinitis is a common painful shoulder disorder, characterized by the deposition of calcium in the tendons of the rotator cuff muscles. It occurs most often in people between the ages of 30 and 50 and is more prevalent in women. In addition to the calcium deposits, symptoms include acute pain, reduced range of motion and impaired shoulder function. Purpose: The purpose of this literature review is to analyse various physiotherapeutic approaches for the treatment of calcific tendinitis and to evaluate their effects on pain reduction, range of motion improvement and shoulder function enhancement. Methods: A literature search was performed in the PubMed database using the following combination of keywords: "calcific AND (tendinopathy OR tendinitis OR tendonitis) AND (shoulder OR rotator cuff)". Results: Six studies were analysed. Two studies investigated the effectiveness of extracorporeal shock wave therapy compared to combined approaches (extracorporeal shock wave therapy with kinesiotape and a combination of radial and focused extracorporeal shock wave therapy). One study evaluated the effectiveness of ultrasound-guided percutaneous lavage compared to extracorporeal shock wave therapy, and another compared ultrasound-guided needling with extracorporeal shock wave therapy. One study examined the effectiveness of low-level laser therapy, while another explored the effects of therapeutic ultrasound combined with exercise. The results showed that ultrasound-guided percutaneous lavage and ultrasound-guided needling achieved the best outcomes in reducing calcifications and pain. Extracorporeal shock wave therapy was also effective in improving function and reducing pain, with combined approaches showing superior results. Low-level laser therapy improved range of motion and reduced the number of calcifications, whereas therapeutic ultrasound combined with exercise did not achieve comparable effectiveness to the other interventions. Discussion and conclusion: The reviewed interventions effectively reduce pain, increase range of motion, and improve shoulder functionality in patients with calcific tendinitis, with ultrasound-guided percutaneous lavage and ultrasound-guided needling showing the highest efficacy. Extracorporeal shock wave therapy and combined approaches, such as extracorporeal shock wave therapy + kinesio taping or a combination of radial and focused extracorporeal shock wave therapy, showed promising results as practical and accessible first-line treatments. Low-level laser therapy proved beneficial as a complement to exercise, whereas therapeutic ultrasound alone was not as effective. A multimodal approach combining different interventions appears promising for achieving better therapeutic outcomes; however, further research is required to determine the optimal strategy.
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