Skip to main content
🎥 Chapters
00:00 Understanding Calcific Tendinitis
0:37 Extracorporeal Shockwave Therapy is the solution for Calcific Tendinitis
1:16 How ESWT works: breaking up scar tissue, adhesions, and calcification
1:51 Studies supporting ESWT: neovascularization, cartilage regrowth, inflammation reduction
2:37 Research on the Effectiveness of ESWT for Calcific Tendinitis
3:58 Success Rates of ESWT treatment compared to control groups for Calcific Tendinitis
4:25 Extracorporeal Shockwave Therapy (ESWT) versus Conventional Surgery for Calcific Tendinitis

Shoulder Pain/Calcific Tendinitis and Shockwave Therapy

Low energy focused shockwave therapy can help your calcific tendinitis. Whether it’s your supraspinatus tendon, biceps tendon, peroneal tendon, triceps tendon or others, extracorporeal shockwave therapy has your tendinitis covered.

Extracorporeal Shockwave Therapy (ESWT) isn’t just another treatment option; it’s a beacon of hope for those trapped in the grips of calcific tendinitis.  Tendinitis can turn the simplest tasks into painful challenges. However, imagine the joy of raising your arm overhead without wincing in agony, swinging a golf club without fear of triggering excruciating pain, or simply reaching for a shelf without hesitating. ESWT has the power to transform everyday struggles into moments of triumph.

Science of Shockwave Therapy and Calcific Tendinitis

The science behind ESWT lies in its ability to harness the power of shockwaves to penetrate at precise depths into the affected tissue, disrupting and disintegrating calcium deposits while stimulating the body’s natural healing mechanisms. These shockwaves break up the rigid and brittle adhesions within the tissue, triggering a cascade of biological responses that promote tissue regeneration and repair. Studies have shown that ESWT increases blood flow to the affected area, stimulates the production of growth factors and cytokines, and enhances cell proliferation and tissue remodeling.  The result is new collagen formation in the place of the scar tissue.

With each shockwave treatment, the burden of pain lifts, replaced by a renewed sense of vitality and possibility.

Is shockwave therapy safe and effective?

Moreover, low energy focused shockwave offers a non-invasive alternative to traditional treatments for calcific tendinitis, such as corticosteroid injections or surgical intervention. There are many studies that compare ESWT and other modalities and, whether it be cortisone injections, PRP, surgery, PT or others, ESWT comes out on top when it comes to efficacy and safety. Unlike invasive procedures that carry inherent risks and lengthy recovery times, ESWT is performed on an outpatient basis and boasts zero to minimal side effects. You will be able to resume your daily activities without skipping a beat. This makes ESWT a preferred choice for those seeking effective, yet gentle, solutions for calcific tendinitis, without compromising on safety or convenience.

Remember to chose low energy focused shockwave over an imposter called, “radial shockwave”. We have seen first-hand people come in our office after being bruised and battered by radial shockwave but never have this happen with the Piezowave low energy focused shockwave machine.

ESWT has the power to restore hope, vitality, and joy to those affected by calcific tendinitis. It’s not just about treating a condition; it’s about reclaiming a life filled with endless possibilities and moments of pure, unbridled happiness.

WHAT IS CALCIFIC TENDONITIS OF THE SHOULDER? Shoulder Pain from Calcific Tendonitis and Frozen Shoulder is helped with ESWT

Frozen shoulder is adhesions (calcification) in the joint capsule of the shoulder. To break it down, calcific tendonitis is a calcification of the tendons of the rotator cuff muscles in your shoulder.  It starts when there is inflammation from an injury or micro-trauma in the shoulder.  The tendons heal by collagen forming cells called fibroblasts.  With calcific tendonitis, on the other hand, fibroblasts are replaced with osteoblasts.  Osteoblasts make a bone-like tendon.  Therefore, these are bone forming cells that, literally, stimulate bone growth in the tendons of the shoulder.  

It follows that when rotator cuff tendons calcify, the space between the tendon and the top of the shoulder (acromion) decreases and this causes impingement. This leads to further tendonitis and bursitis.

Calcific tendonitis tends to give some of the following SYMPTOMS:

  • Decreased shoulder mobility
  • Shoulder weakness
  • Soreness that is worse in the morning
  • Inflammation/swelling
  • Shoulder makes sounds on movement
  • Palpable painful lump on the tendon
  • Pain moving arm overhead


  1. First of all, stop painful activities and apply heat (no anti-inflammatories)
  2. Most importantly, regain range of motion by breaking up calcifications with ESWT in our Los Gatos office
  3. Mobilize scapular movement with adjustments and exercises (see below for some exercises)
  4. While doing all of this, optimize spinal movement to restore neurology to shoulder
  5. At the prescribed time, strengthen rotator cuff muscles (see below)
  6. Now, build on your strength by adding challenging neuromuscular movements
  7. Finally, get back to your Bay Area life of fun and work


Piezowave ESWT being used to treat frozen shoulder

Dr. Fields of San Jose, CA demonstrating the use of ESWT for shoulder dysfunction

The Piezowave 2 sends acoustic waves traveling the speed of sound into your calcified tendon. The wave energy causes wave-like movement of the tissue.  Because it is pliable, normal tissue just ripples.  However, calcified tissue breaks up like hard spaghetti that is bent. As a result, there is a cascade of events that spawn healing. First, new blood vessels come into the injured tendon (this is called angiogenesis). This allows your body to bring in healing properties and to flush out old inflammatory waste products.  Most noteworthy is new collagen fibers are allowed to grow and flourish. Consequently, you are left with a stronger and more adaptable tendon that is better able to handle the mechanical stresses of life.


You can reach Dr Fields for in-person (Los Gatos and San Jose, California) or telehealth appointments here.

Dr Adam Fields is a practicing chiropractor in the Bay Area in Northern California and helps people daily in his office with many challenges that can be helped by shockwave therapy from tendinopathies, arthritis, cartilage regeneration, post surgical scar tissue, pelvic pain, altered biomechanics and more. He uses Endonasal Cranial Adjusting, the Muncie Technique, Extracorporeal Shockwave Therapy (ESWT), Class IV Laser Therapy, posture correction, lifestyle modification, muscle work, and other techniques to help his patients.



Research papers on ESWT are extensiveLet’s be very clear, the research on calcific tendonitis and ESWT is excellent. The success rate is between 78% and 91%[1, 2, 3, 4, 5, 6, 7, 8, 9, 10].  In a study with patients between 40 and 50 years of age, ESWT fragmented the calcifications which resulted in full range of motion and complete pain relief even 2 years post treatment [11].

Furthermore, studies show via x-ray that the calcium deposits can be broken up and eliminated and that the more they are broken up the better the result [12].

It just gets better.  MRI analysis has shown extracorporeal shockwave therapy not to have caused any damage to bone or soft tissue[13, 14].

In addition, Rompe et al showed such improvement he stated that extracorporeal shockwave therapy has equal or better results than surgery in people with calcific tendonitis of the shoulder [15][16].

With such great results, there’s no reason to wait.  Come visit our Los Gatos location- (408) 274-2244


  1. Cacchio A, Paoloni M, Barile A, Don R, de Paulis F, Calvisi V, Ranavolo A, Frascarelli M, Santilli V, Spacca G: Effectiveness of radial shock-wave therapy for calcific tendinitis of the shoulder:single-blind, randomized clinical study. Phys Ther. 2006, 86 (5): 672-82.PubMedGoogle Scholar
  2. Daecke W, Kusnierczak D, Loew M: Long-term effects of extracorporeal shockwave therapy in chronic calcific tendinitis of the shoulder. J Shoulder Elbow Surg. 2002, 11 (5): 476-80. 10.1067/mse.2002.126614.PubMedView ArticleGoogle Scholar
  3. Hsu CJ, Wang DY, Tseng KF, Fong YC, Hsu HC, Jim YF: Extracorporeal shock wave therapy for calcifying tendinitis of the shoulder. J Shoulder Elbow Surg. 2008, 17 (1): 55-9. 10.1016/j.jse.2007.03.023.PubMedView ArticleGoogle Scholar
  4. Jakobeit C, Winiarski B, Jakobeit S, Welp L, Spelsberg G: Ultrasound-guided, high-energy extracorporeal shock-wave treatment of symptomatic calcareous tendinopathy of the shoulder. ANZ J Surg. 2002, 72 (7): 496-500. 10.1046/j.1445-2197.2002.02423.x.PubMedView ArticleGoogle Scholar
  5. Krasny C, Enenkel M, Aigner N, Wlk M, Landsiedl F: Ultrasound-guided needling combined with shock-wave therapy for the treatment of calcifying tendonitis of the shoulder. J Bone Joint Surg Br. 2005, 87 (4): 501-7. 10.1302/0301-620X.87B4.15769.PubMedView ArticleGoogle Scholar
  6. Pan PJ, Chou CL, Chiou HJ, Ma HL, Lee HC, Chan RC: Extracorporeal shock wave therapy for chronic calcific tendinitis of the shoulders: a functional and sonographic study. Arch Phy Med Rehab. 2003, 84 (7): 988-93. 10.1016/S0003-9993(03)00010-8.View ArticleGoogle Scholar
  7. Peters J, Luboldt W, Schwarz W, Jacobi V, Herzog C, Vogl TJ: Extracorporeal shock wave therapy in calcific tendinitis of the shoulder. Skeletal Radiol. 2004, 33 (12): 712-8. 10.1007/s00256-004-0849-8.PubMedView ArticleGoogle Scholar
  8. Pleiner J, Crevenna R, Langenberger H, Keilani M, Nuhr M, Kainberger F, Wolzt M, Wiesinger G, Quittan M: Extracorporeal shockwave treatment is effective in calcific tendonitis of the shoulder. A randomized controlled trial. Wien Klin Wochenschr. 2004, 116 (15-16): 536-41. 10.1007/BF03217707.PubMedView ArticleGoogle Scholar
  9. Rompe JD, Burger R, Hopf C, Eysel P: Shoulder function after extracorporal shock wave therapy for calcific tendinitis. J Shoulder Elbow Surg. 1998, 7 (5): 505-9. 10.1016/S1058-2746(98)90203-8.PubMedView ArticleGoogle Scholar
  10. Wang CJ, Ko JY, Chen HS: Treatment of calcifying tendinitis of the shoulder with shock wave therapy. Clin Orthop. 2001, 387: 83-9.PubMedView ArticleGoogle Scholar
  11. Spindler A, Berman A, Lucero E, Braier M: Extracorporeal shock wave treatment for chronic calcific tendinitis of the shoulder. J Rheum. 1998, 25 (6): 1161-3.PubMedGoogle Scholar
  12. Wang CJ, Yang KD, Wang FS, Chen HH, Wang JW: Shock wave therapy for calcific tendinitis of the shoulder: a prospective clinical study with two-year follow-up. Am J Sports Med. 2003, 31 (3): 425-30.PubMedGoogle Scholar
  13. Jurgowski W, Loew M, Cotta H, Staehler G: Extracorporeal shock wave treatment of calcareous tendonitis of the shoulder. J Endourol. 1993, 7 (Suppl 1): 13-17.Google Scholar
  14. Loew M, Daecke W, Kusnierezak D, Rahmanzadeh M, Ewerbeck V: Shock wave application in calcifying tendinitis of the shoulder: prediction of outcome by imaging. Arch Orthop Trauma Surg. 2000, 120: 43-8.Google Scholar
  15. Rompe JD, Eysel P, Hopf C, Krischek O, Vogel J, Burger R, Jage J, Heine J: [Extracorporeal shockwave therapy in orthopedics. Positive results in tennis elbow and tendinosis calcarea of the shoulder]. Fortschritte der Medizin. 1997, 26 (18): 29-33.Google Scholar
  16. Rompe JD, Zoellner J, Nafe B: Shock wave therapy versus conventional surgery in the treatment of calcifying tendinitis of the shoulder. Clin Orthop. 2001, 387: 72-82.PubMedView ArticleGoogle Scholar
  17. Int J Prev Med. Jul 2014; 5(7): 875–881.PMCID: PMC4124565 Babak Vahdatpour, Parisa Taheri,  Abolghasem Zare Zade, and Saeed Moradian Efficacy of Extracorporeal Shockwave Therapy in Frozen Shoulder Int J Prev Med. Jul 2014; 5(7): 875–881.PMCID: PMC4124565