Shock wave therapy for rotator cuff disease with or without calcification In people with rotator cuff disease, moderate-certainty evidence (downgraded due to bias) shows that shock wave therapy probably does not improve pain and function compared with placebo, and low-certainty evidence (downgraded due to bias and lack of accuracy) shows there may be no improvement in those with a pain reduction of 50% or more and participant-reported success. We are uncertain if withdrawals or side effects differed between groups due to small number of events. It did not appear to matter if participants had calcific deposits or not. We are uncertain if higher doses of shock wave therapy have benefits with more side effects compared with lower doses, as there was only low- or very low-certainty evidence available, and we cannot recommend a particular treatment dose. Side effects included treatment-related pain, bruising and bleeding although these were generally minor and short-lived. Rare and serious side effects, including loss of blood supply and bone death, while possible, were not reported.
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