In chronic calcific tendinitis (6 months or longer), the calcium deposits often harden into a chalk-like form, making natural absorption difficult. At this stage, direct detachment of the calcium using a fine needle and ultrasound-guided barbotage are effective methods. Fire acupuncture softens the fibrotic tissue surrounding the hard calcium deposits and induces neovascularization to promote the breakdown of the calcium. Thread embedding therapy stimulates collagen regeneration within the tendons, while bee venom acupuncture suppresses chronic inflammation and exhibits immunomodulatory effects. In Korean medicine, hard calcifications in the chronic stage are viewed as solidified lumps formed from stagnant blood and waste products that have hardened over time. Since this condition indicates a significant depletion of the body's proper energy, simply removing accumulated waste makes it difficult to prevent recurrence. Dongjedang employs a two-pronged strategy: using thick needles and fire needles to loosen the hardened lumps while simultaneously replenishing the vital energy of the liver and kidneys and blood with herbal medicine tailored to the patient's constitution, thereby creating an internal environment where the tendons can regenerate themselves. Changes in the size of the calcifications are tracked using ultrasound every 6 to 8 weeks.