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Calcific tendonitis (shoulder)

Calcific tendonitis (shoulder)

Blow-drying your hair, hanging up your clothes or pulling your jumper over your head – anyone who has ever had persistent shoulder pain knows that the joint is indispensable for many movements. Everyday life can become torture for patients with painful calcific tendonitis.

Our shoulder experts at Schoen Clinic specialise in treating calcific tendonitis. We work with you to find the precise diagnosis, advising on the best course of action to resolve your condition and assist in relieving your pain.

What is calcific tendonitis?

Calcific shoulder tendonitis happens when a naturally occurring mineral present in the human body (hydroxyapatite) deposits within the tendons of the group of muscles around the shoulder (the rotator cuff). This condition is more frequent in women than men and is more common in those aged between 30 and 60 years. Patients with this condition often experience long-lasting, slow-onset or intermittent shoulder pain. This is caused by the inflammatory response of the body to resorption of the calcification. This happens as part of the natural cycle of the calcific deposit, which consists of three phases: formative, resting and resorptive, with the latter being the most painful. Sometimes a minor trauma or repetitive movement might irritate the tendon and the shoulder becomes very painful without any real resorption of calcific crystals.

Symptoms of calcific tendonitis

Patients with shoulder calcification complain about different symptoms which can vary depending on the stage of the disease and the location and size of the calcific deposit. Those affected who are in the early phase of shoulder calcification often show no signs or symptoms. As the condition progresses, minor pain can become worse, or in extreme cases severe. If you experience sudden pain in a resting position or the pain increases with movement, this may indicate calcific tendonitis. Signs & symptoms you may have calcific tendonitis:

  • Shoulder pain or discomfort
  • Pain is concentrated either on the front or back of your shoulder and down the arm
  • Sudden or gradual increase of pain (as calcium deposits build-up)
  • In severe cases, pain may immobilise the arm and interfere with sleep

Causes: how does calcific tendonitis develop?

The exact cause of this condition remains mostly unknown, although thyroid gland dysfunction, metabolic diseases (e.g. diabetes) and genetic predisposition have been proposed to play a role in increasing the risk of being affected.

The clinical picture may vary from patient to patient, depending upon which phase the deposit is in, but pain is certainly the hallmark of this condition. Such pain can be at times quite severe, to the point it will interfere with sleep and daily activities. A feeling of “catching” in the shoulder may also be present, therefore mimicking a condition of “shoulder impingement”, which can overlap calcific tendonitis in several ways. For this reason, it is essential to gain an accurate diagnosis of the condition so it can be treated appropriately.

How we diagnose calcific tendonitis

Calcium deposits within the tendon substance can be easily identified with a shoulder X-ray or alternatively an ultrasound scan. More advanced imaging techniques (such as CT scans and/or MRIs), are usually not needed and may be recommended only in cases of high suspicion, or in order to exclude other sources of pain in your shoulder.