Ultrasound Guided Barbotage for Calcific Tendinitis in Manchester
Shoulder Barbotage (or needle lavage as it is referred to in the US) is a minimally invasive technique used to treat Calcific Tendonitis, a condition where calcium deposits form within the rotator cuff tendons in the shoulder, causing intense severe pain in the shoulder. We use the Barbotage procedure to treat patients in our Manchester clinic.
What's on this Page:
CQC Regulated Clinic
Ultrasound Guided Procedure
No GP Referral Required
Manchester and Burnley Clinic
ABOUT THE PROCEDURE
What is Barbotage?
Shoulder Barbotage (or needle lavage as it is referred to in the US) is a minimally invasive technique used to treat Calcific Tendonitis, a condition where calcium deposits form within the rotator cuff tendons in the shoulder, causing intense severe pain in the shoulder.
The most common affected tendon is the Supraspinatus tendon.
During the procedure, a needle is inserted into the into the calcified deposit to break up and aspirate the calcification, providing relief from the discomfort and pain.
Barbotage is performed under ultrasound guidance, allowing the clinician to accurately locate the calcium deposit and break it down with a needle.
This approach offers a non-surgical alternative to patients and has a high success rate in alleviating the pain. Many patients report significant pain relief with this procedure.
The risks associated with Barbotage are relatively low compared to surgery, and the recovery time is generally quicker than that of surgery.
This makes barbotage an attractive option for those suffering from persistent shoulder pain due to calcifications within the rotator cuff tendonitis.
Carrying out the procedure under ultrasound guidance ensures that the treatment is precise, which is essential for optimal results and reducing potential complications.Â
In this article we highlight the procedure, effectiveness and potential risks of ultrasound-guided Barbotage.
This should hopefully help you in making an informed decision about your treatment options for calcific tendonitis.
80%
We find around 80% of patients report pain relief after undergoing barbotage procedure.
45 Minutes
At MyMSK Clinic the consultation and Barbotage procedure is usually done within 45-60 Minutes.
No
Surgery required. (Barbotage if suitable, can potentially be a minimally invasive alternative to surgery)
STEP BY STEP
How the procedure works
The Doctor will examine your shoulder to confirm it is calcific tendinitis causing your pain. Usually an ultrasound scanner or X-Ray is used to diagnose the calcium deposit. At our MSK clinic in Manchester we have an inhouse Ultrasound scanner.
Prior to the procedure, the affected area is sterilised with alcohol and chlorhexidine, and a local anaesthetic such as lidocaine is administered to reduce discomfort during treatment.
During the Barbotage Procedure, the clinician guides the needle using ultrasound and inserts the needle into the calcium deposit (The area is usually numb after having injected lidocaine around it during the preparation phase).
The technique involves lavage—the flushing or pumping the calcium deposit with saline or local anaesthetic solution—and aspiration, which is the suction of the calcific deposits.Â
This process helps to break down and remove the calcium.
Following the procedure, patients may experience some discomfort or swelling, which is usually treated with painkillers or Ice packs.
Often Patients return to normal activities within 48-72 Hours.
The patient is often advised not to do strenuous activities with the shoulder for 10 to 14 days.
The clinician may recommend gentle exercises or physical therapy to strengthen the rotator cuff tendon which helps in recovery and maintain the mobility and flexibility of the joint.Â
This is important to prevent a condition called frozen shoulder.
GOOD TO KNOW
Risks and Considerations
Infection Risk: There is a small possibility of skin or joint infection following Barbotage, which while uncommon, can occur.
Pain and Inflammation: Some patients might experience acute pain and inflammation, or post-injection bursitis.
- Tendon Rupture: There is the possibility of tendon rupture, though this is thankfully quite rare.
Recurring Symptoms: In some instances, symptoms can return, requiring further treatment.
Chronic Pain: There is a potential for ongoing pain in the affected area after the procedure especially if the calcific deposit is large and is unable to be completely broken down.
- Minor Complication Rates: The overall rate of minor complications has been reported at 7%.
If the calcified deposit is too large to be removed via barbotage, or if symptoms persist after treatment, surgical options may be discussed. For the majority of patients, however, barbotage offers effective relief without the need for surgery.
Outcomes
The barbotage procedure is a relatively successful procedure for patients with calcific tendinitis of the shoulder.
Ultrasound Guided Barbotage has been associated with high success rates in treating calcific tendinitis. Clinical studies have reported good clinical success rates with this technique, with an improvement in pain and shoulder function.
Prognosis
Improved outcomes result from the accurate injection and targeting of calcium deposits and thorough removal via image guided needling and lavage.Â
However, reduced improvement in pain scores post-procedure sometimes can be linked to particular tendon characteristics and symptom duration. If the calcified deposit is quite large and unable to be removed, often a surgical procedure may be necessary.Â
Occasionally the calcium deposit may be too small to be removed in which case the pain may recur later on during a flare.
When patients are considering an Ultrasound Guided Barbotage, they should be aware of what to expect before and after the procedure.Â
This brief summary provides essential information regarding the pre-procedure expectations and the subsequent recovery and rehabilitation phases.
Pre-ProcedureÂ
Patients may also be informed that the treatment has a high success rate in reducing pain, backed by research showing over 70% improvement in symptoms of pain and functionality.
The shoulder is scanned and the area is marked carefully. Local Anesthetic is applied before the procedure to ensure patient comfort.
Recovery and Rehabilitation
Post-procedure care is essential for effective recovery. Patients should:
Modification of activity:Â Limited use of the affected area may be necessary initially especially for 2 weeks post procedure.
- Physical therapy:Â Mild discomfort is normal and as the pain decreases the patient should start exercises to strengthen the temporarily weakened rotator cuff tendon.
The rehabilitation exercises are important to regain full function, and a tailored plan will be given to them by their clinician.
How Much Does Barbotage Procedure Cost?
£350
The cost of Barbotage Procedure can fluctuate between different providers. This can be due to a variety of factors including Location and clinic reputation.
At MyMSK Clinic in Manchester we charge £350 per shoulder for Barbotage. This price includes the cost of the consultation.
If you are considering this treatment, book a consult with us at My MSK Injection Clinic Manchester. The Doctor will perform a thorough examination and suggest whether Barbotage is suitable for you. No GP is Referral required.
COMMON QUESTIONS
Frequently Asked Questions
This section addresses common queries regarding the barbotage procedure for calcific tendinitis of the shoulder.
The costs for a barbotage procedure can vary depending on the clinic. Here at MyMSK we charge £350 for this procedure. This also includes the steroid injection post procedure.
Following a barbotage procedure, patients may experience acute pain, bruising, and swelling. Infection is rare, with 1 in 10,000 cases reported, and there may also be instances of post-injection bursitis which itself is painful but often settles down after 7-10 days.
The procedure is performed under local anaesthesia to minimise discomfort, but patients may still feel some pain as the needle is inserted and the calcium deposits are aspirated. The clinician will do their best to minimise the pain during the procedure.
After the procedure, patients are generally advised to rest the affected shoulder for 2 weeks and apply ice to manage swelling. Pain killers can be taken, and patients should follow any specific aftercare instructions provided by their doctor.
Recovery times can vary, but many patients return to normal activity levels after 4-6 weeks.
Potential complications from barbotage include tendon rupture, although this is uncommon. The procedure is considered relatively safe, with considerable benefits in reducing the pain and discomfort associated with calcific tendinitis.
Yes! our Clinic in Manchester City Centre allows us to treat Manchester based patients. It is easily accessible to patients in the Greater Manchester area, including Salford, Bury, Bolton, Oldham, Altrincham, Wilmslow and more.
To Arrange a consultation simply visit our Booking Page or call us on 0333 772 9655.
