Calcific tendonitis is a common painful syndrome of the shoulder region that affects mainly women of 40 up to 60 years of age. It usually runs incomprehensible at the initial stage and in some patients, produces severe and sometimes protracted pain during the resolution phase of the disorder. Complex regional pain syndrome and the frozen shoulder syndrome are the main entities that commonly fill the differential diagnosis list of the syndrome. Specific criteria apply to any of these painful syndromes but occasionally some of them may co-exist and makes diagnosis and appropriate treatment a quite challenging task.
We present a case with bilateral calcific tendonitis of the shoulder that was complicated with causalgia and reflex sympathetic syndrome that consist the two arms of the complex regional pain syndrome. After failure of the conservative regimens (non-steroidal anti-inflammatory medications, opioids, physiotherapy, intra-articular steroids) to treat both pain and causalgia, we applied repetitive trials of electroacupuncture together with auricular acupuncture and one trial of intravenous regional anesthesia. The patient gradually responded to treatment and regained normal, painless mobility of the shoulders. She returned to normal life activities after 5 years of debilitating pain at the right shoulder that was topped by a coup of similar pain in the left shoulder.
We believe that electroacupuncture deserves further clinical research in painful musculoskeletal disorders like calcific tendonitis.
Key words: Electroacupuncture, auricular acupuncture, complex regional pain syndrome, calcific tendonitis, intravenous regional anesthesia
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