Calcific Tendonitis is a condition that occurs when calcium deposits form on the shoulder tendons. This can cause acute pain and discomfort. It affects the tendons of the rotator cuff, which connects the muscles around your shoulder to the upper arm.
The calcium deposits that cause the pain and discomfort form usually in the supraspinatus tendon of the rotator cuff, and the reason this happens is unclear. It seems to cause more pain than degenerative calcification, which is essentially ‘wear and tear’ as we age. In fact, this condition occurs in younger patients and in many cases can go by itself.
The pain of calcific tendonitis can be confused with other shoulder conditions. When the calcium is deposited in the tendon, the pain can be fairly moderate. However the pain can become very acute when deposits are being resorbed, and patients lose mobility and it can affect the ability to sleep. Pain can be constant, in a single episode or regular flare-ups over several years with no pain in between them.
An X-ray or ultrasound will be required to confirm the presence of calcium deposits in the tendon. The patient will most likely need several X-rays over time to keep track of any changes in the amount of calcification. This will help to determine whether the patient requires surgery or whether it might heal by itself.
Initially treatment will be anti-inflammatory medication and rest. If the pain is acute, patients may even need a cortisone (steroid) injection to ease the pain.
During the most painful stage (whilst the calcium deposits are being resorbed) urgent treatment may be required. Therefore, calcific deposits can be needled under ultrasound guidance combined with a local anesthetic and steroid injection. Following this physiotherapy can help.
If these methods have been tried and haven’t helped, surgery may be required to remove the calcium deposits.