This trial randomized patients with calcific tendonitis to receive ultrasound-guided needling followed by high-energy shockwave therapy (Group I, n=40) or shock-wave therapy alone (Group II, n=40). After mean follow-up of 4.1 months, those in the Group I had better clinical results as measured by Shoulder Constant scores as well as radiographs showing a significant decrease in calcific deposits when compared to Group II. In addition, arthroscopic removal of deposits was avoided in 80% of those in Group I compared to 55% in Group II. There were no severe side effects in either group.