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. At the end of the Barbotage procedure, the doctor may also inject a corticosteroid solution, to reduce inflammation of the area, if it is safe to do so.
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. We advised resting the area for 2 weeks.
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.
OUR CLINICS
Where we offer Barbotage Procedure
We treat patients at two clinics in the North West. Easy to reach for Greater Manchester, Salford, Bury, Bolton, Oldham and the wider Lancashire area.
Our Reviews
He takes the time to properly assess each patient and consider the most appropriate treatment options. What I particularly value is that he doesn't simply recommend or perform injections without good clinical reason — every decision is carefully considered with the patient's best interests in mind.
It's reassuring to have a knowledgeable and trusted clinician to refer my patients to, and I would highly recommend Dr Akhtar and the team at MyMSK Clinic.
Khuram - Full Motion Physio
Consultation with no pressure to continue with the treatment. I had a Caudal epidural injection yesterday and have just completed Shopping trip around the local supermarket virtually pain free.
Thank you soo much Dr Akhtar
Over the next few days, the pain in my shoulder eased significantly, and the movement in my arm improved dramatically. I am now almost back to full range of motion. Dr. Akhtar was professional, knowledgeable, and reassuring throughout, and I felt I was in very capable hands. I would highly recommend him to anyone seeking prompt and effective treatment.
The injection has helped me greatly and I would not hesitate to recommend Dr Akhtar for any treatments in his clinic.
Fantastic service.
I feel much more confident about the treatment plan we discussed. I can highly recommend his service.
Michael P.
I saw Dr Amir Akhtar for a painful recurrence of sesamoiditis / forefoot pain. He assessed the area carefully, used ultrasound to check what was going on, and only proceeded with injection once he was satisfied it was appropriate. I valued that he was clear, direct, and clinically grounded rather than just rushing through the appointment.
He also explained the wider mechanical picture well, including how compensation from other ankle problems may be contributing. The treatment was carried out there and then, and the whole process felt efficient and professional.
A helpful and thorough service. I would recommend them.
Overall, I would certainly recommend this clinic and clinician. It was excellent care. I am pleased to say that I am noticing some improvement in my knee following the injection and am now saving to have my other knee treated. I will definitely be returning to this clinic.
She received ultrasound guided hydrodissection of the Baxter’s nerve, and since the treatment she has reported a really positive improvement. Her pain has reduced significantly, and she feels much better in herself, more comfortable driving and able to go out for walks again, which she hasn’t been able to do for quite some time.
The improvement has been remarkable and we’re very grateful. She has also noticed that she is now able to move her toe more easily, and the pain in her heel at night has reduced, helping her rest more comfortably.
Thank you for the care, support, and treatment it has made a real difference.
I definitely feel the injection has worked and I'm hoping it allows me to get some quality of life back.
Dr AKhtar has your best interests at heart at al time. Dr AKhtar was really thorough when. investigating my hip and knee.
It was so refreshing to meet Dr Akhtar,
I will recommend him to my family and friends should they need a specialist.
I booked my appointment online and got so much more than I expected on the day of my appointment.
The level of detail that things were explained to me in was fantastic but also done in such a way that it wasn’t overwhelming. I’m at the start of a journey to recovery but have so much confidence I am in great hands and off to the best possible start!!
The evening following my appointment I received some emails of; advice, follow up care, recommendations of the best splint to purchase, images taken from my scans and even a copy of my letter that is going to the GP!
What a fantastic service, one would have to wait weeks if not months for this kind of feedback on the NHS and the cost of everything was very reasonable too.
Thank you very much for everything , I really appreciate your time and approach towards my issue.
Thanks 😊
Dr Akhtar was everything you could hope for in a specialist: friendly, incredibly knowledgeable, and, most importantly, truly listened. He took the time to understand my pain and concerns, and for the first time since the accident, I genuinely felt hopeful. I’m only 48 hours post-injection, but already the difference in my outlook is huge.
A special thank you goes to Safi, who has been nothing short of exceptional. Safi has handled my endless emails with patience, kindness, and professionalism, and their support has made this whole process so much easier. They genuinely deserve recognition for outstanding customer care.
I was originally going to wait seven days before leaving a review, but honestly, this clinic has already proven itself. I would return here time and time again without hesitation, and I would recommend My MSK to absolutely anyone in need of expert, compassionate care.
Thank you to Dr Akhtar, Safi, and the entire team for giving me hope again. An effortless 5 stars. 🌟🌟🌟🌟🌟
Got an appointment really quickly and the consultation was in depth with a scan showing me the exact problem. Treatment options were given to me with associated costs along with exercises to support in the interim.
Dr Akhtar is really helpful and knowledgeable and I can’t thank him enough for his support which included a direct referral to hospital for other support.
Thank you
I had an amazing experience with this company.
Dr Akhtar was reliable, honest and operates with integrity.
I would highly recommend MYMSK Clinic.
Took my partner to see amir
Could not praise him highly enough
Partner was in pain for 5 days,hardly any sleep.after a few cortisone injections she was able to sleep.
Dr amir tells you the way it is
Did a full report for the gp recommending future action required
Then we got a phone call today of amir to see how my partner was doing.
Dr akhtar very professional in his work
From the very beginning, Dr. Akhtar showed exceptional professionalism, honesty and genuine care, taking the time to explain the procedure in detail and addressing all my concerns.
He explained any symptoms that may occur post injection and the time for it to become effective.
Thank you doctor!
I felt really at ease and was able to explain what was wrong with me in a relaxed atmosphere.
Can ‘t recommend enough
Also the building is so beautiful inside😊
He was very informative about what he was going to do and what was causing the issue.
He was very friendly and I will 100% be recommending his services to anyone that needs help.
I would highly recommend this clinic, very professional staff, with special commendation to Dr Akhtar. An experienced clinician in the field of MSK medicine, a credit to his profession!
However during the consultation Dr Aktar explain that the injection might not be the best course of action, he gave me some excellent advice and explained in detail what was wrong and how that was causing the painful symptoms.
I left feeling much more informed about my situation and after following his instructions my symptoms have improved massively.
I really appreciated the good advice and felt it was far more beneficial than other places who would have just taken my money for the injection and not really considered the actual root cause.
Would recommend to anyone!
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 2 week. We advise it can take up to 4-6 weeks for optimal changes
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.
Dr Amir Akhtar
certification
GMC Registered Doctor and CQC Regulated Clinic
