Conservative Treatments for Calcific Tendinopathy of the Shoulder: A Systematised Narrative Review
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- Background: Rotator cuff calcific tendinopathy is a common cause of shoulder pain, characterized by calcium deposits within the rotator cuff tendons. It may cause pain, functional limitation, sleep disturbance, reduced quality of life, and work-related disability. Several conservative treatments are available, but their relative effectiveness remains debated. Objective: This narrative review aimed to summarize conservative treatment options for rotator cuff calcific tendinopathy and evaluate their effects on pain, function, calcification resorption. Methods: A literature search was conducted in PubMed, Embase, Cochrane Library, and CINAHL. Studies published between 2015 and 2025 were included if they involved adults with symptomatic shoulder calcific tendinopathy and assessed conservative or minimally invasive treatments. Risk of bias was assessed using RoB 2 and JBI tools. Results: Ten studies were included. Most treatments improved pain and function, but no intervention showed clear superiority. ESWT provided symptomatic benefits, although its clinical relevance remains uncertain. Ultrasound-guided lavage and needling reduced calcifications, but radiological improvement was not consistently linked to better clinical outcomes. Corticosteroid injections offered short-term pain relief, while PRP showed no clear long-term superiority. Rehabilitation and kinesio taping appeared mainly useful as supportive adjuncts. Conclusion: No conservative treatment can currently be considered clearly superior. Management should be individualized and based on symptoms, function, quality of life, risks, costs, and patient preferences rather than imaging findings alone. Further high-quality studies are needed.