Ultrasound-guided prolotherapy with adjunctive nutritional and metabolic support may lead to rapid radiographic improvement in large multilobulated shoulder calcific tendinitis
A 49-year-old man with acute severe shoulder pain (10/10 VAS) and a large 3 cm multilobulated calcific deposit received ultrasound-guided prolotherapy (10% dextrose with 0.2% lidocaine) plus adjunctive nutritional and metabolic support (vitamin C, vitamin D, magnesium, MSM, L-arginine). At two weeks, pain improved to 2/10, range of motion normalized, and radiographs showed near-complete resorption of the calcific deposit.
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Ultrasound-guided prolotherapy with adjunctive nutritional and metabolic support may lead to rapid radiographic improvement in large multilobulated shoulder calcific tendinitis The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 32/100 (low).
The Claim
Ultrasound-guided prolotherapy with adjunctive nutritional and metabolic support may lead to rapid radiographic improvement in large multilobulated shoulder calcific tendinitis
This conclusion is most relevant to: A 49-year-old man with acute severe right shoulder pain due to large multilobulated calcific tendinitis.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Rapid Radiographic Improvement in Large Multilobulated Shoulder Calcific Tendinitis After Ultrasound-Guided Prolotherapy and Adjunctive Nutritional and Metabolic Support: A Case Report. (Cureus, 2026) —
How It Works
The proposed biological pathway:
- ▸Prolotherapy induces local inflammation and tissue repair
- ▸Nutritional support (vitamin C, D, magnesium, MSM, L-arginine) may enhance collagen synthesis and calcium metabolism
- ▸Combined approach promotes resorption of hydroxyapatite deposits
- ▸Result: rapid pain relief and near-complete radiographic resolution
Who Might Benefit
Evidence fit by population:
- ▸A 49-year-old man with acute severe right shoulder pain due to large multilobulated calcific tendinitis
Recommended Dose
Prolotherapy: 10 mL total (5 mL glenohumeral, 5 mL subacromial) of 10% dextrose with 0.2% lidocaine; nutritional support: not specified per component
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Single case report, cannot establish causality
- ▸No control group or blinding
- ▸Confounding from concurrent physical therapy and activity modification
Frequently Asked Questions
What is prolotherapy?▼
Prolotherapy involves injecting an irritant solution (e.g., dextrose) to stimulate local inflammation and tissue healing.
How long did it take for the patient to improve?▼
Pain and range of motion improved within two weeks, with near-complete resorption of the calcific deposit on radiographs.
Is this treatment suitable for all cases of calcific tendinitis?▼
No, this is a single case report; the approach may be considered for selected patients with large, multilobulated deposits before invasive procedures.
What nutritional supplements were used?▼
Vitamin C, vitamin D, magnesium, methylsulfonylmethane (MSM), and L-arginine.
References
- 1.Yoon Y, Lee J, Lim J, Hwang JH, Suryadi T, Suhaimi A, Lam KHS. “Rapid Radiographic Improvement in Large Multilobulated Shoulder Calcific Tendinitis After Ultrasound-Guided Prolotherapy and Adjunctive Nutritional and Metabolic Support: A Case Report..” Cureus, 2026. PMID: 42131637 DOI: 10.7759/cureus.106864