New Hope for Shoulder Pain Caused by Calcific Tendonitis

For many active adults, the shoulder joint can become a source of pain as we age. Because of the shoulder’s complex structure and function, shoulder pain can have many causes, and accurate diagnosis is key to successful treatment. One common source of shoulder pain is the buildup of calcium crystals in the tendons surrounding the shoulder, especially the tendons of the rotator cuff, a condition known as calcific tendonitis of the shoulder.

Calcific tendinitis, also called calcific tendinosis, is a buildup of calcium deposits on soft tissue surrounding the shoulder that is often accompanied by pain and inflammation. The exact underlying cause of the calcium deposits is not known, and the condition is most prevalent in females over age 40, but it can occur in adults of both sexes at any age. Symptoms typically do not appear until after the calcium deposits have formed.

Symptoms include:

• Unexpected onset of shoulder pain

• Pain with normal shoulder movement

• Stiffness in the shoulder joint

• Reduced shoulder mobility and range of motion

• Pain that occurs while sleeping

• Tenderness in tissues surrounding the shoulder joint

• Reduced muscle mass in the shoulder region

Diagnosis begins with a review of the patient’s health history and symptoms. The practitioner will conduct tests for shoulder strength, stability and range of motion. Imaging by Xray or ultrasound can reveal the location and extent of calcium deposits.

Calcific tendonitis usually resolves itself over time, but treatment interventions can help speed the healing process. In about 75 percent of cases, the condition resolves itself in 3 to 6 months with conservative care.

Common treatment options include:

• Physical therapy exercises to improve shoulder stability and range of motion

• Heat and ice treatments to reduce pain and inflammation

• NSAIDs and other anti-inflammatory drugs to help with pain and inflammation

• Corticosteroid injections to target inflammation

• ESWT (extracorporeal shock wave therapy) to stimulate blood flow to the affected area and speed the healing process

• Ultrasound guided debridement, where a thin metal needle is inserted to irrigate, dissolve and aspirate the calcium deposit.

In rare cases, when calcium deposits do not respond to conservative treatments, arthroscopic shoulder surgery may be performed to remove the calcium deposits. However, surgery to remove calcium deposits can result in a gap in the rotator cuff tendon where the deposit was located, which may require an additional surgical procedure to repair the damaged rotator cuff tissue. Recovery from this type of surgery can take up to six months.