Effectiveness of Acetic Acid Iontophoresis and Ultrasound on Calc
Journal of Women's Health Care

Journal of Women's Health Care
Open Access

ISSN: 2167-0420


Case Report - (2016) Volume 5, Issue 5

Effectiveness of Acetic Acid Iontophoresis and Ultrasound on Calcifying Tendonitis of the Shoulder

Cuadros MF1* and Moro OSP2
1Rehabilitation and Physical Medicine Department, Santisima Trinidad’s General Foundation Hospital, Salamanca, Spain
2Rehabilitation and Physical Medicine Department, Santa Cristina’s University Hospital, Madrid, Spain
*Corresponding Author: Cuadros MF, Rehabilitation and Physical Medicine Department, Santisima Trinidad’s General Foundation Hospital, Salamanca, Spain, Tel: 0034620314558 Email:

Keywords: Calcifying tendonitis; Shoulder pain; Iontophoresis; Ultrosund therapy

Case Report

Calcifying tendonitis (CT) is a common cause of shoulder pain and labour inability. The origin is the deposit of calcium phosphate/ carbonate over a previously healthy tendon. The pathogenesis is unknown. CT is common in middle-aged working-women. It affects supraspinatus tendon. It is associated with smoking. Occupational risk factors are awkward positions and lifting weights [1].

Three stages with clinical/histological/radiological correlation are described, and sometimes overlap:

1) Pre-calcification

2) Calcification: a) Formative b) Resorptive

3) Post-calcification

The diagnosis is clinical and radiological [1].

CT treatment is initially conservative. Different electrotherapy techniques are useful reducing pain but not the calcification [1].

Iontophoresis is a non-invasive technique that increases the penetration of transdermal substances through the skin layers with the help of electric current, based on physical-chemical principles of attraction and repulsion of charges [2]. In 1955 Psaki and Carrol introduced acetic-acid Iontophoresis as an effective treatment in shoulder CT [2]. However, there are few and controversial studies to support its use. Low-frequency-Ultrasound works synergistically with Iontophoresis; it could help disintegrate and reabsorb calcification due to their mechanical and thermal effects [3].

We present the case of a 44-years-old woman, who reported a twomonth history of shoulder pain which increased with movements. The pain worsened at night. The patient was right handed, not smoker, and she worked as a teacher. Anti-inflammatory drugs had no alleviation of symptoms. Radiography showed a resorptive calcification of the right supraspinatus tendon. After 10 sessions of 5% acetic-acid Iontophoresis (4.7 mA×10 minutes) and Continuous Ultrasound (1 W/ cm2/1 MHz×5 minutes) over calcification, pain decreased from 10/10 to 5/10 on the Visual Analogical Scale (VAS), and calcification decreased from 24 mm to 3 mm, evaluated by 100%-size, posterior anterior radiographies of the right shoulder (Figure 1).


Figure 1: Calcifying tendonitis of the shoulder 10 sessions of AA Iontophoresis+US

We confirmed that the combination of 5% acetic-acid Iontophoresis and continuous Ultrasound is a safe and simple technique, capable to reduce pain and calcification.


  1. Cuadros MEF, MoroOSP, Blasco JN, García VR, Pardeiro AO (2015) Calcifying tendonitis of the shoulder: risk factors and effectiveness of physical therapy. Occup Med Health Aff 3:220.
  2. Alvarez EC (2015) Prospective study comparing the three results obtained with three treatments of electrotherapy in the calcified tendinopathy of the supraspinatus. Doctoral Thesis, Valladolid, Spain.
  3. Toro JR, Monje MR, Fuentes EC, Rebollo AYG, Sánchez EB (2001) Treatment of calcific shoulder tendinitis by iontophoresis with acetic acid and ultrasound. Rehabilitation 35:166-170.
Citation: Cuadros MF, Moro OSP (2016) Effectiveness of Acetic Acid Iontophoresis and Ultrasound on Calcifying Tendonitis of the Shoulder. J Women's Health Care 5:328.

Copyright: © 2016 Cuadros MF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.