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.

Understanding Calcific Tendonitis

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 Treatment Options

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.

Calcific Tendonitis Treatment in NYC

Shoulder pain and stiffness can be debilitating, leading many patients to believe that surgery is the only option. However, the vast majority of shoulder dysfunction can be completely rectified with conservative care. Moreover, surgery can be costly and painful, and frequently does not resolve the issue.

At NYDNR, we understand shoulder mechanics and what it takes to improve and restore function. We have cutting edge technologies at our fingertips, like ESWT and ultrasound guided needling procedures. Our therapists combine traditional and innovative therapies to treat pain, restore range of motion and optimize stability. Don’t let shoulder pain keep you from enjoying your favorite sports and activities. Call us today, and get back in the game of life with NYDNRehab.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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