While most people have probably never heard of calcific tendonitis, it is one of the most common causes of pain in the shoulder. The condition, which is the build up of calcium deposits in the tendon or muscle, can actually occur anywhere in the body.
This is why it’s important to understand effective types of calcific tendonitis treatment, as well as the causes and symptoms because early identification and intervention will help improve recovery and decrease any associated downtime.
What is Calcific Tendonitis?
The build up of calcium in the tendons and muscles can lead to inflammation and pain, a condition referred to as calcific tendonitis.
While a person can develop the issue in various parts of the body, the shoulder’s rotator cuff is where most people experience the condition.
Calcific tendonitis can occur in athletes, people with physically demanding jobs, those who lead active lifestyles and even those with relatively sedentary ones.
While calcium deposits in tendons and muscles can be spread out, they can also accumulate in one area and grow bigger and bigger, causing irritation and severe pain if not addressed.
Calcific Tendonitis Generally Occurs in Three Stages:
1. Pre-Calcific Stage
During the Pre-Calcific Stage at the start of the condition, an individual may experience pain with movement, or a loss in range of motion. During this phase, there are also changes going on at the cellular level of the body.
2. Calcific Stage
The Calcific Stage can cause serious pain when calcium is released from the cells creating deposits. Eventually the body will resorb the calcium deposits.
3. Post-Calcific Stage
In the Post-Calcific Stage, the calcium deposits are replaced by normal, healthy tissue and symptoms like stiffness and range of motion start to improve.
What Causes Calcific Tendonitis?
It’s not completely clear why some people develop the issue and others don’t, though the wear and tear that comes with age might be a factor.
Calcific tendonitis tends to affect people between the ages of 40 and 60, with women being slightly more at risk of the condition.
Other issues that may cause calcific tendonitis include:
- Metabolic diseases such as diabetes
- Abnormal cell growth
- Thyroid gland irregularities
- The body’s production of anti-inflammatory agents
- Genetic predisposition
- Trauma or injury to the tendon
While anyone can develop this painful condition, those who play sports or work in occupations that require a lot of overhead movements can be at higher risk.
Recognizing the early symptoms of calcific tendonitis is important because addressing the issue quickly will help reduce the time it takes to heal and recover.
Calcific Tendonitis Symptoms
In many cases, people suffering from calcific tendonitis symptoms think they are experiencing frozen shoulder symptoms because many of the symptoms overlap with the two conditions.
Some people with this condition may notice a gradual build up of symptoms, while others might just start feeling pain suddenly.
In either case, people experiencing pain, stiffness, and discomfort in the shoulder should see a doctor if they notice any of the signs.
Calcific Tendonitis Symptoms May Also Include:
- Pain so severe it disrupts normal activities, such as sleep
- Discomfort or pain that comes with moving the shoulder
- Decrease in shoulder range of motion
- Tenderness in the rotator cuff area
- Sudden stiffness or pain in the shoulder joint
It’s important not to ignore the symptoms and see a physician for an accurate diagnosis and treatment.
Calcific Tendonitis Treatment
Diagnosing calcific tendonitis will first start with a discussion about the symptoms and all recent activity.
A physical examination of the area will also be needed and most physicians will usually perform x-rays or an MRI to rule out any other issues and get a clear picture of what’s going on in the affected area.
Treatment approaches for calcific tendonitis will range from conservative to more invasive, but can include some of the following:
Calcific Tendonitis Treatment Methods
1. Pain Medications
Over-the-counter, non-steroidal anti-inflammatory pain medications, such as ibuprofen (Advil) or naproxen (Aleve) can be used as directed to reduce pain and inflammation, while resting the injured shoulder.
2. Corticosteroid Injections
If over-the-counter pain medications don’t provide enough relief, corticosteroid or steroid injections may be needed to further reduce inflammation and swelling.
3. Shockwave Therapy
Shockwave Therapy is an effective, non-invasive treatment approach to break up calcium deposits that cause calcific tendonitis.
Shockwave Therapy is formally called Extracorporeal Shock Wave Therapy (ESWT), but there are variations such as Radial Shockwave Therapy (RSWT) and Focused Shockwave that refer to the type of device used.
Shockwave Therapy uses high or low energy pressure waves (shockwaves) directed at the injured area to break up calcium deposits, reduce inflammation, increase blood flow, and speed up the healing process.
Higher frequency shockwaves may work faster, but these can be adjusted lower to provide maximum comfort for each patient depending on his or her condition.
Shockwave Therapy is a highly recommended method for treating calcific tendonitis.
4. Physical Therapy
Physical Therapy will help educate patients on proper techniques in overhead movements as well as effective stretches and calcific tendonitis exercises that will lessen the likelihood of continued injury.
Over time, physical therapists will incorporate range-of-motion exercises, isometric movements, and weight bearing activities to regain strength and improve flexibility. Physical therapy may be needed if surgery is necessary.
5. Percutaneous Needling
More invasive than the previous approaches, percutaneous needling involves using a needle to make small holes in the skin that allow a physician to remove the build up calcium deposits.
Lavage is similar to percutaneous needling except the needles are inserted into the affected area and a saline solution is injected to rinse the area and break up the calcium deposits for removal.
A small percentage of patients with calcific tendonitis will need a surgical procedure to remove the build up of calcium deposits. Surgery is the most invasive treatment.
Many times, this requires arthroscopic surgery that uses a small camera to locate the calcium deposits and remove them while rinsing the area. Sometimes an open surgery is necessary.
Calcific tendonitis may go away on its own for some individuals, while others find relief from the treatment methods outlined here.
It’s important for people to understand that calcific tendonitis symptoms may be related to other shoulder issues. So it’s necessary to speak with a doctor whenever shoulder pain or range of motion causes a problem before it gets worse.
Photo Credit: X-ray image by Elmundo