Calcific tendinitis is a relatively rare condition caused by a build-up of calcium deposits in your tendons. It can occur anywhere in the body, but the shoulder joint is most commonly affected and, in some cases, the condition results in severe pain. Women between the ages of 40 and 60 are most often affected by calcific tendinitis, although it can affect men and women of any age.
Causes of Calcific Tendinitis
Calcific tendinitis is inflammation of the tendons caused by a build-up of calcium. It is associated with ageing, but experts are unsure exactly what predisposes some people to the condition. The shoulder is most often affected although calcific tendinitis can occur anywhere within the body. The condition can sometimes trigger associated conditions like frozen shoulder.
There are three stages to the development of calcific tendinitis. In the first stage – the pre-calcific stage – you may start to notice some mild pain when moving and a decline in range of motion. The next stage – the calcific stage – is when calcium is released from the cells. These form calcium deposits which the body starts to detect, resulting in pain and inflammation which can be severe. The post-calcific stage sees the range of movement start to improve as calcium deposits dissolve and are replaced by healthy tissue.
Symptoms of Calcific Tendinitis
The symptoms can vary depending how severely you are affected. However, it is common to experience:
- Sudden shoulder pain which can be intense when you move your shoulder.
- Disrupted sleep due to pain and discomfort.
- Shoulder stiffness and a decline in range of movement.
- Tenderness in the area of the rotator cuff.
Diagnosing Calcific Tendinitis
Sometimes people confuse the symptoms of calcific tendinitis with frozen shoulder or shoulder arthritis as the symptoms are similar. It is important to have a proper diagnosis so you can receive the correct treatment. Your doctor will carry out a physical examination and ask about your symptoms and medical history. A simple xray is usually all that is noted to make the diagnosis. However, if the calcium is in an usual position it may only be detected on an ultrasound or MRI scan.
Because the pain is often described a being worse than childbirth, in the first instance many patients will present to an emergency medical centre for pain relief. Making the diagnosis and accessing correct early treatment is vital, as over time the chances of treatment being successful can reduce due to hardening of the calcium.
Treating Calcific Tendinitis
Mild calcific tendinitis can be managed with at-home treatments such as rest, heat or cold compresses applied to the affected area, anti-inflammatory medication and physiotherapy exercises. In most cases, calcific tendinitis will eventually go away on its own, however it can be linked to other issues such as frozen shoulder, rotator cuff tendinitis and bursitis. If you are experiencing severe pain, there are a range of possible treatments which are effective at reducing symptoms.
These include:
- Ultrasound-guided barbotage which is performed under local anaesthetic to aspirate, or suck out, the calcium and break up the remaining shell. A steroid injection is performed at the same time to dampen down the inflammation in the shoulder
- Shockwave therapy which aims to break up the calcium by delivering shockwaves to the tendon
s. Normally a few treatments are needed and can be quite painful. The effectiveness of this treatment compared to barbotage is not fully researched yet. - Keyhole surgery to remove the calcium deposits. This is only needed in around 10% of cases when other non-surgical treatments have not worked.
If you have unexplained shoulder pain and are concerned that you may have calcific tendinitis or other associated conditions, contact us for advice about diagnosis and treatment. Receiving a prompt diagnosis will enable you to embark on the best course of treatment at the earliest opportunity and give you the best chances of making a speedy recovery.
Orthopaedic Consultant & Surgeon | London
Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist).
Telephone: 020 376 15987
Email: admin@thamesshoulderandelbow.co.uk
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