Definition

What is Calcific tendonitis of the shoulder?

Calcific tendonitis of the shoulder of the shoulder happens when calcium deposits form on the tendons of your shoulder. The tissues around the deposit can become inflamed, causing a great deal of shoulder pain.

There are two different types of calcific tendonitis of the shoulder:

  • Degenerative calcification
  • Reactive calcification

The wear and tear of aging is the primary cause of degenerative calcification. As we age, blood flow to the tendons of the rotator cuff decreases. This makes the tendon weaker. Due to the wear and tear as we use our shoulder, the fibers of the tendons begin to fray and tear, just like a worn-out rope. Calcium deposits form in the damaged tendons as a part of the healing process.

Reactive calcification is different. Why it occurs is not clear. It doesn’t seem to be related to degeneration, though it is more likely to cause shoulder pain than degenerative calcification. Doctors think of reactive calcification in three stages. In the pre-calcific stage, the tendon changes in ways that make calcium deposits more likely to form. In the calcific stage, calcium crystals are deposited in the tendons. Then they begin to disappear. The body simply reabsorbs the calcium deposits. Ironically, it is during this stage that pain is most likely to occur. In the post-calcific stage, the body heals the tendon, and the tendon is remodeled with new tissue.

How common is Calcific tendonitis of the shoulder?

This condition is fairly common. This condition is typically seen in adults between 40 and 60 years old. Women are also more likely to be affected than men. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Calcific tendonitis of the shoulder?

While the calcium is being deposited, you may feel only mild to moderate pain, or even no pain at all. For some unknown reason, calcific tendonitis becomes very painful when the deposits are being reabsorbed. The pain and stiffness of calcific tendonitis can cause you to lose motion in your shoulder. Lifting your arm may become painful. At its most severe, the pain may interfere with your sleep.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you or your loved one has any signs or symptoms listed above or you have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Calcific tendonitis of the shoulder?

The exact cause of calcific tendonitis is still unknown.
Reactive calcification is even more of a mystery. This type of problem occurs in younger patients and seems to go away by itself in many cases.

Risk factors

What increases my risk for Calcific tendonitis of the shoulder?

There are many risk factors for Calcific tendonitis of the shoulder, such as:

Severe wear and tear, aging, or a combination of the two are involved in degenerative calcification. Some researchers think that calcium deposits form because there is not enough oxygen to the tendon tissues. Others feel that pressure on the tendons can damage them, causing the calcium deposits to form.

Also, it’s thought that calcium buildup may stem from:

  • Genetic predisposition
  • Abnormal cell growth
  • Abnormal thyroid gland activity
  • Bodily production of anti-inflammatory agents
  • Metabolic diseases, such as diabetes

Please consult with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Calcific tendonitis of the shoulder diagnosed?

Your doctor will take a detailed medical history and do a thorough physical exam of your shoulder. The pain of calcific tendonitis can be confused with other conditions that cause shoulder pain. An X-ray is usually necessary to confirm the presence of calcium deposits. The X-ray will also help pinpoint the exact location of the deposits.
You will probably need to get several X-rays over time. This will help your doctor keep track of the changes in the amount of calcification. By following the changes in the calcium deposits, your doctor can determine whether the condition will heal by itself or perhaps require surgery.

How is Calcific tendonitis of the shoulder treated?

Most cases of calcific tendonitis can be treated without surgery. In mild cases, your doctor may recommend a mix of medication and physical therapy or a nonsurgical procedure.

Medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered to be the first line of treatment.

Be sure to follow the recommended dosing on the label, unless your doctor advises otherwise.

Your doctor may also recommend corticosteroid (cortisone) injections to help relieve any pain or swelling.

Nonsurgical procedures

In mild-to-moderate cases, your doctor may recommend one of the following procedures. These conservative treatments can be carried out in your doctor’s office.

Extracorporeal shock-wave therapy (ESWT): Your doctor will use a small handheld device to deliver mechanical shocks to your shoulder, near the site of calcification.

Higher frequency shocks are more effective, but can be painful, so speak up if you’re uncomfortable. Your doctor can adjust the shock waves to a level you can tolerate.

This therapy may be performed once a week for three weeks.

Radial shock-wave therapy (RSWT): Your doctor will use a handheld device to deliver low- to medium-energy mechanical shocks to the affected part of the shoulder. This produces effects similar to ESWT.

Therapeutic ultrasound: Your doctor will use a handheld device to direct a high frequency sound wave at the calcific deposit. This helps break down the calcium crystals and is usually painless.

Percutaneous needling: This therapy is more invasive than other nonsurgical methods. After administering local anesthesia to the area, your doctor will use a needle to make small holes in your skin. This will allow them to manually remove the deposit. This may be done in conjunction with ultrasound to help guide the needle into the correct position.

Surgery

About 10 percent of people will need surgery to remove the calcium deposit.

If your doctor opts for open surgery, they’ll use a scalpel to make an incision in the skin directly above the deposit’s location. They’ll manually remove the deposit.

If arthroscopic surgery is preferred, your doctor will make a small incision and insert a tiny camera. The camera will guide the surgical tool in removal of the deposit.

Your recovery period will depend on the size, location, and number of calcium deposits. For example, some people will return to normal functioning within the week, and others may experience post-surgical pain that continues to limit their activities. Your doctor is your best resource for information about your expected recovery.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me cope with Calcific tendonitis of the shoulder?

Rehabilitation without surgery

Your doctor or physical therapist will teach you a series of gentle range-of-motion exercises to help restore movement in the affected shoulder. Exercises such as the Codman’s pendulum, with slight swinging of the arm, are often prescribed at first. Over time, you’ll work up to limited range-of-motion, isometric, and light weight-bearing exercises.

Rehabilitation after surgery

Recovery time after surgery varies from person to person. In some cases, full recovery may take three months or longer. Recovery from arthroscopic surgery is generally quicker than from open surgery.

After either open or arthroscopic surgery, your doctor may advise you to wear a sling for a few days to support and protect the shoulder.

You should also expect to attend physical therapy sessions for six to eight weeks. Physical therapy usually begins with some stretching and very limited range-of-motion exercises. You’ll typically progress to some light weight-bearing activity about four weeks in.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 27, 2018 | Last Modified: March 27, 2018