Extracorporeal shock wave therapy in treating calcific supraspinatus tendinopathy

Given the wide spread application of ESWT in treating different tendinopathies, the EBPG investigated the efficacy/effectiveness of ESWT (high or low energy shock wave) in treating tendinopathies in general. [...] At the end of a mean follow up of 110 days post treatment, the authors reported that the improvement from baseline of the Constant-Murley score (the primary end point) was significant in the high energy group with a mean gain of 12.5 points (range: -20.7 to 47.5 points). [...] The authors concluded that high energy ESWT significantly improved symptoms in patients with refractory calcifying tendinitis of the shoulder after three months follow up; however, the calcific deposits remained unchanged in size in the majority of patients. [...] These differences in the length of follow up may have influenced the primary outcome of interest in this study, the pain and functional levels. [...] It should be noted that the authors did not take into account these differences in the statistical analysis, regardless of the fact that the statistical analysis, by default due to no loss in follow up, was done according to the intention to treat principle.