Severe Shoulder Pain? Beware of Calcific Tendinitis

September 19, 2022
While calcium deposits in the shoulder tendons (calcific tendinitis) is not a particularly common condition, when the area where calcium has accumulated becomes inflamed, it can cause severe pain and discomfort. Calcium deposits can form in any tendon in the body, such as in the shoulders, ankles, and knees, but they most often cause serious pain in the shoulder rotator cuff tendon used to lift the arm, known as the supraspinatus tendon.

What are the causes of Calcific Tendinitis?
The exact cause of the disease is not yet fully known, but it is believed that degenerative changes due to aging and/or damage due to accidents or general wear and tear from everyday use contribute to the condition. In addition, there may be a link to minor accidents that are often exacerbated by exercise and sports. The disease usually affects people between the ages of 40-60 and is more common in women than in men. 

What are the symptoms of Calcific Tendinitis?

In the early stages of calcific tendinitis, the patient may experience no pain at all, or perhaps mild or moderate pain only. Symptoms of the condition may be exhibited in a variety of forms as follows:

  • Sudden shoulder pain or stiffness
  • Intense pain with shoulder movement
  • Severe pain that disrupts sleep
  • Reduced range of motion
The most common pain characteristic of this condition is the result of severe inflammation, causing the patient to experience pain and fever similar to that of a shoulder infection. When this is the case, it is considered a medical emergency. 

How is Calcific Tendinitis diagnosed?

Your healthcare provider will examine your shoulder, ask about your symptoms and review your medical history. Additional diagnostic tools and tests may be used to confirm the diagnosis as follows:

How to treat the Calcific Tendinitis?

There are two main types of treatment methods for calcific tendinitis: conservative treatment and surgical treatment.

  • Conservative Treatment: About 90% of patients can be improved without the use of surgery. conservative treatment can be administered as follows: 
    • Steroid injections into the affected site are the best way to reduce inflammation and pain. Many patients are wary of steroid injections, but your physician will only use it in cases where it is truly necessary.
    • Steroid tablets may be necessary or beneficial for some patients, but should only be used under the direction of a physician.
    • Non-steroidal anti-inflammatory drugs (NSAIDs) and pain relievers are another way to reduce inflammation and pain, but may not be particularly effective for treatment of this condition.
    • Physical therapy, shockwave therapy, and therapeutic ultrasound have all been reported to have good results. If, however, you have increased pain after undergoing treatment, you should halt treatments and consult a specialist. 
    • Lavage treatment involves the injection of saline into calcium deposits to help dissolve and remove them.
    • Any activities that use the shoulder joint should be reduced.
  • Surgical Treatment: Arthroscopic surgery is the standard surgical method used to remove calcium deposits. At the same time, your doctor will consider sutures to repair torn shoulder tendons, if any. Generally speaking, while a tendon is in the acute inflammatory phase, surgical treatment is not advised as bleeding and deterioration of shoulder tendons can occur under these conditions, making repair and suturing difficult. Instead, palliative care is recommended in the acute inflammatory phase and only in chronic cases or in cases where patients have been unresponsive to other treatments is surgery considered as an appropriate course of action for a better outcome. 
Arthroscopic surgery to remove calcium deposits and repair the shoulder tendons is a form of minimally invasive surgery. Postoperative recovery takes approximately 6 weeks. Patients may need to wear an arm sling after surgery to prevent movement of the shoulder joint. 

Is Calcific Tendonitis a recurring condition?
Calcific tendonitis can be recurring, but some patients go months or even years without any symptoms after receiving treatment.
How can I prevent Calcific Tendonitis in the shoulder?
Although calcific tendonitis cannot be prevented altogether, there are steps you can take that may reduce your risk, such as controlling your weight within healthy levels, exercising regularly, and, if you develop pain in your shoulder, avoiding participation in strenuous shoulder-related activities until you have it checked out by a specialist for proper diagnosis.

Calcific tendonitis is a condition that causes pain and suffering in a patient’s daily life. As such, if there is pain in the shoulder joint and you suspect this may be an issue for you, consult a specialist physician to prevent any possible complications, such as a rotator cuff tear or a severely frozen shoulder.

At the Sports Medicine and Joint Center at Bumrungrad Hospital, our medical team specializes in patient care for all types of musculoskeletal issues, whether they are related to sports injuries, accidents, or injuries due to age-related deterioration. Our center offers an integrated approach, combining expertise in both sports medicine and orthopedic surgery in order to care for and swiftly restore you to a good quality of life once again. Bumrungrad International Hospital aims to prevent, diagnose and treat all types of musculoskeletal disorders and injuries with our team of specialists with the most advanced capabilities, expertise, and technology.

Compiled by Dr. Wichan Kanchanatawan, Orthopedic Surgery, Sports Injuries, Sports Medicine Specialist and Chief of Sports Medicine & Joint Center at Bumrungrad

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