CALCIFIC TENDINITIS OF THE SHOULDER
Calcific tendinitis of the shoulder
Calcific tendinitis of the shoulder, known medically as tendinosis calcarea, is a common degenerative and inflammatory condition of the shoulder tendons in which calcium crystals are deposited in the tendons of the rotator cuff. The tendon most often affected is the supraspinatus tendon, which runs above the humeral head beneath the acromion.
Depending on their size, position and stage, these calcium deposits irritate the surrounding tissue, cause inflammation of the bursa (bursitis subacromialis) and lead to pain that can be severe – particularly with overhead movements, when lying on the shoulder or under sudden load. In many cases the shoulder becomes considerably less mobile, in some cases to the point of a so-called "frozen shoulder".
The condition often runs in episodes and can last for weeks or months. Although calcific tendinitis can potentially resolve on its own, in its acute stage it frequently brings considerable restrictions at work and in everyday life.
How does calcific tendinitis develop?
How it develops
The exact cause is not yet fully understood, but it is thought that a reduced blood supply to the tendon, degenerative processes and metabolic changes all play a part.
Calcific tendinitis typically passes through three stages:
- Formative stage – calcium is slowly deposited in the tendon
- Resting stage – the deposit remains, but may cause no symptoms
- Resorptive stage – the body begins to break the deposit down; this is usually when the pain is most severe
Symptoms
The symptoms of calcific tendinitis (tendinosis calcarea) vary with the stage of the condition and the extent of the calcium deposit. Some patients notice nothing for a long time – in other cases severe, at times barely bearable pain sets in suddenly. The acute inflammatory stage in particular, when the body is "dissolving" the calcium deposit, can provoke a marked reaction.
Pain
Typically shoulder pain that shoots in suddenly – often with no identifiable trigger – and becomes much worse with overhead movements
Restricted movement
Reduced mobility of the shoulder, sometimes with a protective posture or stiffening caused by the pain
Disturbed sleep
Disturbed sleep from peaks of pain at night, particularly when lying on the affected side
Treatment options
Treatment of calcific tendinitis depends on the stage of the condition, the extent of the symptoms and the size and position of the calcium deposit. One point is worth knowing: the calcification can resolve spontaneously, so the aim of treatment is primarily to relieve pain, preserve movement in the shoulder and support the body in resorbing the deposit itself.
In most cases no operation is needed – non-surgical measures often bring a clear improvement. Surgery is only worthwhile in persistent cases or where the deposit is mechanically blocking the joint.
Treatment options
Non-surgical and surgical – we will find the right approach for you
Medication
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac help to relieve pain and inflammation.
Physiotherapy
Physiotherapy for calcific tendinitis aims to improve movement in the shoulder, correct muscular imbalances and, through targeted mobilisation and strengthening of the rotator cuff, achieve lasting relief for the joint.
Shockwave therapy
A modern, non-invasive treatment in which high-energy sound waves are directed at the calcium deposit. The aim is to break the deposit up mechanically and stimulate the body to resorb it.
Arthroscopic removal of the calcium deposit
Arthroscopic removal is a minimally invasive procedure in which the calcium deposit is removed through a keyhole arthroscopy. Inflamed bursal tissue can be removed at the same time (bursectomy) and, where necessary, an existing impingement treated in the same operation. The aim is rapid pain relief and restoration of shoulder function.
Frequently asked questions about calcific tendinitis
Here you will find answers to the questions most often asked about calcific tendinitis and its treatment.
What exactly is calcific tendinitis of the shoulder?
How do the calcium deposits form?
Who is particularly affected?
Which symptoms are typical?
How is the diagnosis made?
Can calcific tendinitis heal on its own?
Is an operation always necessary?
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