Calcific tendinitis of the shoulder occurs when calcium deposits build up in the shoulder tendons, causing pain, inflammation and limiting mobility. The condition can be particularly difficult for people who rely on shoulder movement for daily tasks or sports activities. Although it usually resolves on its own, intervention may be needed if symptoms are severe or persistent.
What is calcific tendinitis of the shoulder?
Calcific tendinitis of the shoulder is a condition in which calcium deposits form in the tendons of the rotator cuff muscles, most commonly the supraspinatus tendon. The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, providing stability and allowing a wide range of movements. Calcification within the tendons occurs when calcium phosphate crystals accumulate, causing the affected tendon to become stiff and painful.
Calcium accumulation can disrupt the normal function of the tendon, causing irritation and inflammation of the surrounding tissue, resulting in significant discomfort. Although calcific tendinitis can occur in any tendon, the shoulder is one of the most common sites of this condition due to the pressure and repetitive movements that this joint undergoes.
What causes calcific tendinitis of the shoulder
The exact cause of calcific tendinitis of the shoulder remains somewhat unclear, but several factors may contribute to the development of calcium deposits in the tendons. These causes can be grouped into biological, mechanical and degenerative factors.
Biological factors
Various metabolic factors or imbalances in the body's calcium regulation system may play a role in the development of calcific tendinitis. In particular, conditions that affect calcium metabolism, such as hyperthyroidism (overactive thyroid gland) or kidney disease, may increase the likelihood of calcium deposits forming in the tendons. υπερπαραθυρεοειδισμός (υπερδραστήριος παραθυρεοειδής αδένας) ή η νεφροπάθεια, μπορεί να αυξήσουν την πιθανότητα σχηματισμού εναποθέσεων ασβεστίου στους τένοντες.
Mechanical factors
Repetitive shoulder movements, particularly overhead activities such as lifting, throwing or swimming, can put excessive strain on the rotator cuff tendons. Over time, this repetitive strain can contribute to the formation of microcracks in the tendon, leading to a build-up of calcium as part of the body's attempt to repair the damage. People involved in high-intensity physical activities or sports are at a higher risk of developing calcific tendinitis of the shoulder.
Degenerative changes
As people get older, the tendons in the shoulder can become more prone to wear and tear. In this context, the body's ability to repair tendons and control calcium deposits decreases, making older people more vulnerable.
Symptoms of calcific tendinitis of the shoulder
The symptoms of calcific tendinitis of the shoulder can vary from patient to patient depending on the extent of calcium buildup and the degree of inflammation present in the shoulder joint. The most common symptoms include:
- Pain, which usually worsens with activity or when the shoulder is moved in certain ways. The pain is often felt in the front or side of the shoulder and may radiate down the arm.
- Limited range of motion due to stiffness caused by calcium deposits that make it difficult to raise the arm above the head or perform simple tasks.
- Swelling and inflammation around the shoulder joint, which may be accompanied by a burning sensation and redness.
- Pain at night, especially when patients lie on the affected shoulder, due to pressure on the tendons.
- A sensation of grinding when moving the arm, particularly when moving over the head.
To diagnose calcific tendinitis of the shoulder a physical examination is necessary to evaluate the symptoms and based on the findings, a doctor will recommend imaging tests to confirm the diagnosis and determine the most appropriate treatment approach. Imaging tests to diagnose the condition usually include X-rays (to visualize calcium deposits and rule out other possible causes of shoulder pain), ultrasound (to visualise the location and size of calcium deposits within the tendons) or MRI (which provides a more detailed picture of the soft tissue structures of the shoulder and helps to assess the extent of damage and inflammation and to rule out other possible causes of shoulder pain).
How calcific tendinitis of the shoulder is treated
Treatment for calcific tendinitis of the shoulder aims to reduce pain, inflammation and dissolve calcium deposits. Each patient's treatment plan depends on the severity of the condition, their overall health and the extent of the tendon damage.
Conservative treatment
Most cases of calcific tendinitis can be treated conservatively with:
- Rest and limiting activities that aggravate shoulder pain to give the tendon time to heal.
- Medication to reduce inflammation and relieve pain.
- A targeted program of physiotherapy to improve shoulder mobility, strengthen the muscles around the shoulder joint and reduce pain.
- Seldom corticosteroid injections, for cases of severe pain and to reduce inflammation.
- Shockwave therapy
- Ultrasound-guided Barbotage (or needle lavage) as a minimal invasive technique
Surgical treatment
In cases where conservative treatments fail to provide relief or if the calcium deposits are large or deep in the tendon, surgery may be needed, either arthroscopically or by open surgery if the calcium deposits are difficult to reach arthroscopically.
Can calcific tendinitis of the shoulder be prevented?
Prevention of calcific tendinitis mainly involves addressing the risk factors for tendon injury.
- Strengthening the shoulder muscles
- Proper technique and ergonomics, for athletes or people who perform repetitive overhead movements.
- Rest, breaks and avoiding excessive repetitions can help prevent tendon damage.
- A balanced diet, with calcium and vitamin D for bone health.
Calcific tendinitis of the shoulder can significantly affect a person's quality of life. Regardless of the cause, the buildup of calcium deposits in the shoulder tendons can cause painful symptoms. Early diagnosis and conservative treatment are usually sufficient to manage symptoms; however, in more severe cases, surgery may be required to remove calcium deposits and restore normal function.
To find out more about calcific tendinitis of the shoulder, contact us at 6943903343 (secretary) or 6949196061 (doctor) and at orthopedikos-papagiannopoulos.gr and make an appointment.
