Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


OBJECTIVE: The objective of this selective EBM review is to determine whether or not extracorporeal shock wave therapy is effective in treating shoulder tendonitis.

STUDY DESIGN: This review paper analyzes two, double-blind, randomized control trials (RCTs) and one retrospective cohort study. The population included adults with calcified or non-calcified shoulder tendinitis. The intervention was extracorporeal shock wave therapy (ESWT). The groups receiving ESWT in the RCTs were compared to those receiving placebo probes.

DATA SOURCE: Each article was a primary research design published in English after 2015 in peer-review journals.

OUTCOMES: The outcomes measured were patient-oriented evidence that matters, including pain and disability. The outcomes were measured by questionnaires and surveys including NRS, CMS, SPADI, and VAS. The summary of statistics was reported using mean change from baseline, 95% confidence intervals, standard deviations, and p-values.

RESULTS: Lie et al. RCT studied those with non-calcified CRTC tendonitis. There was a statistically significant decrease in mean NRS and CMS score in the group receiving ESWT compared to the control group receiving the placebo probe (p < 0.001; Medicine. 2017;96(35):1-4. doi:10.1097/MD.0000000000007940). Kvalaag et al. RCT studied those with non-calcified and calcified RTC tendonitis. There was no statistically significant difference in the group receiving ESWT with supervised exercises compared to the group receiving sham ESWT with supervised exercises (p = .76); however, both groups had a decrease in mean SPADI score (Am J Sports Med. 2017;45(11):2547-2554. doi: 10.1177/0363546517707505 [doi]). Malliaropoulos et al. retrospective cohort study showed a statistically significant improvement in shoulder pain, remission rate, and recurrence rate in those with calcified shoulder tendinopathy (Musculoskelet Disord. 2017;18(1):x. doi: 10.1186/s12891-017-1873-x [doi]).

CONCLUSION: It is inconclusive as to whether or not ESWT is effective in treating shoulder tendonitis. Two studies showed statistically significant improvements in shoulder pain and function after ESWT, while one study did not. Further studies are needed to determine which specific type of shoulder tendonitis would benefit most from ESWT.