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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

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.

Last updated: Aug 26, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Rapid Radiographic Improvement in Large Multilobulated Shoulder Calcific Tendinitis After Ultrasound-Guided Prolotherapy and Adjunctive Nutritional and Metabolic Support: A Case Report.

observational

Yoon Y, Lee J, Lim J, Hwang JH, Suryadi T, Suhaimi A, Lam KHS · Cureus (2026)

Participants: N/A
Duration: 2 weeks
Intervention: Ultrasound-guided prolotherapy (10% dextrose with 0.2% lidocaine, 5 mL into glenohumeral joint and 5 mL into subacromial space) plus adjunctive nutritional and metabolic support (vitamin C, vitamin D, magnesium, methylsulfonylmethane, L-arginine)
Outcome: Pain (VAS), shoulder range of motion (passive and active), radiographic resorption of calcific deposit
Effect Size: N/A
Population: A 49-year-old man with acute severe right shoulder pain due to large multilobulated calcific tendinitis

Result:

PubMed: 42131637DOI: 10.7759/cureus.106864

Mechanism Graph

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

Limitations

  • ⚠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.

Products

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References

  1. 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
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.