54 patients with painful calcific tendinitis of the shoulder were randomized to receive ultrasound (US)-guided needling with subacromial corticosteroid injection or extracorporeal shock wave therapy (ESWT). The purpose of this study was to determine which conservative treatment offered superior functional restoration and pain relief after 12 months. US-guided needling offered improved calcium deposit eradication, and superior American Shoulder and Elbow Surgeons score, Simple Shoulder Test, and visual analog scale (VAS) pain score compared to ESWT at the 12 month follow-up.