Ayurvedic Management of Supraspinatus Calcific Tendinitis: A Case Report

Abstract

Calcific tendinitis of the shoulder is characterized by deposition of calcium phosphate crystals within the rotator cuff tendons and may present with chronic pain, stiffness and restriction of shoulder movements. The supraspinatus tendon is the most frequently involved site. This case describes the clinical response to a sequential Ayurvedic treatment protocol in a patient with chronic supraspinatus calcific tendinitis. A 65-year-old female with no reported comorbidities presented with gradual-onset left shoulder pain of one-year duration, with night pain, difficulty lying on the affected side and restriction of activities such as combing the hair and touching the opposite shoulder during bathing. She had a history of trauma to the shoulder 10 years earlier, intermittent pain and restricted movements for several years, and a history of heavy weight lifting. Clinical examination showed tenderness around the shoulder, restricted range of motion and positive Empty Can, Belly Press and Hawkins-Kennedy tests. Apley scratch test could not be elicited because of restricted movements, while the Drop Arm test was negative. Ultrasonography of the left shoulder was performed. The patient underwent a sequential treatment protocol such as rooksha sweda , upanaha, choorna pinda sweda, jambeera pinda sweda ,vicharana snehapana ,nasya ,matra vasti each for a period of 7 days and 2 sitting jaloukavacharana  .Internal medications such as amruthotharam kashaya 90 ml twice daily with shaddharana tab ,prasarnyadi kashaya second stage with yogaraja guggulu. Following treatment, pain reduced, sleep improved and shoulder movements increased. Flexion improved from 80° to 130°, while active abduction improved from 70° with pain and restriction to 160°. Tenderness was reduced and the painful arc became negative.