Effectiveness of treatment rotator cuff tendinopathy using extracorporeal shock wave therapy – systematic review of randomized controlled trials

Background
Rotator cuff tendinopathy is otherwise known as rotator cuff inflammation, which usually occurs as a result of sudden trauma or degenerative changes. One of the physical therapies used to treat rotator cuff inflammation is extracorporeal shock wave therapy (ESWT). An increasing number of scientific studies of varying quality are emerging and need to be systematized on a regular basis.

Aims
The aim of this review was to analyze the scientific evidence on the effectiveness of treating rotator cuff tendinopathy using ESWT.

Material and methods
The systematic review was conducted in October 2023. After searching databases such as PubMed, PEDro, Cochrane Library, and applying eligibility criteria, out of 163 studies, 10 papers were included in the review. They were methodologically assessed using the PEDro scale. A total of 819 people with diagnosed rotator cuff tendinopathy were included in the study. The methodology of the study involved comparisons between groups applying different ESWT parameters or comparing ESWT with other treatments. Pain and shoulder function assessment scales were used to evaluate efficacy. Some studies were supported by radiological evaluation.

Results
The study showed that the use of ESWT in rotator cuff tendinopathy is an effective treatment method. A positive therapeutic effect was evident in both short- and long-term follow-up. High-energy ESWT had a higher treatment efficacy than low-energy ESWT.

Conclusions
The results of this review clearly indicate that ESWT is highly effective in the treatment of rotator cuff tendinopathy. However, more randomized clinical trials (RCTs) are needed to determine a specific management protocol, including establishing treatment parameters and determining the number of treatment sessions on a large group of subjects.