What is Calcific Tendonitis?
Calcific Tendonitis refers to the condition in which calcium deposits start building up in your tendons or muscles. This can happen anywhere in the body, but it most often occurs in the rotator cuff. A rotator cuff is a group of tendons and muscles that links your upper arm to your shoulder.
Calcium deposition in the tendon can cause chemical irritation as well as a buildup of pressure in the tendon. This causes discomfort and pain. The pain can be excruciating. It is one of the most excruciating shoulder pains (the other being Frozen Shoulder). In addition to the chemical irritation and discomfort, the chemical deposition reduces the gap between the rotator cuff and the acromion, as well as affecting the rotator cuff’s normal function.
Symptoms of Calcific Tendonitis
When calcific tendonitis develops, most people feel shoulder pain and discomfort. Calcific tendonitis causes discomfort and pain in the front or back of a person’s shoulder, as well as down into the arm.
Extreme symptoms may occur in some people. Pain associated with activity, tenderness to palpation at the involved tendon, and loss of range of movement are the most common symptoms of calcific tendonitis. If the patellar or Achilles tendon is involved, this can cause discomfort and pain in the shoulder when raising the arm above shoulder height, as well as pain in high-impact activities like jumping and running.
The calcium deposits build up in stages, so the pain experienced by a person may come on suddenly or increase gradually and slowly.
The three stages of calcium deposition are as follows:
Pre-Calcification: In the areas where calcium can gradually build up, the body undergoes cellular changes.
The Calcific Stage: Calcium is released from the cells and it begins to accumulate in the body. The body reabsorbs the calcium buildup during this stage, which is the most painful part of the process.
The Post-Calcific Stage: The calcium deposit disappears and is replaced by a healthy tendon.
It is also possible to have calcific tendonitis without experiencing any symptoms.
Causes of Calcific Tendonitis
Doctors are still not sure why some people develop calcific tendonitis whereas others do not. Calcific Tendonitis is a more common condition in adults between the ages of 40 and 60. There is a higher probability of women to develop this condition than men.
The accumulation of calcium deposits can be caused by the following factors:
- Metabolic diseases, like diabetes
- Abnormal growth of cells
- Abnormal thyroid gland activity
- Damaged tendons
- A lack of oxygen supply to the tendons
- Inflammation-fighting chemicals produced by the body
Calcific tendonitis is more common in athletes and people who regularly lift their arms up and down for work, but it can affect anyone.
How can you diagnose Calcific Tendonitis?
If the pain and discomfort in a person’s shoulder persist, then he or she should visit the doctor. The doctor will inquire about a person’s symptoms and medical history at the appointment. The doctor will conduct a physical exam after this. To observe any limitations in your range of motion, they may ask you to raise your arm or make arm circles.
Your doctor will most likely recommend imaging tests after your physical exam to check for calcium deposits or other abnormalities. An X-ray will expose larger deposits, while an ultrasound will assist the doctor in finding smaller deposits missed by the X-ray. Once the size of the deposits has been determined, the doctor will develop a treatment plan that is suited to your specific needs.
The majority of calcific tendonitis cases do not require surgery. In minor cases, your doctor may prescribe a combination of medication and physical therapy, or a non-surgical procedure.
According to NCBI, the first line of treatment is NSAIDs (nonsteroidal anti-inflammatory drugs). The following medications are available to help in treating calcific tendonitis:
- ibuprofen (Advil)
- aspirin (Bayer)
- naproxen (Aleve)
You should be careful to follow the prescribed dosing on the label, unless your doctor recommends otherwise. Corticosteroid injections, which may help relieve pain and swelling, can also be prescribed by the doctor.
1- Therapeutic ultrasound:
In this procedure, a doctor will use a handheld device to focus a high-frequency sound wave to the region where the deposit has built up to break it down. Therapeutic ultrasound is usually painless.
2- Extracorporeal shock-wave therapy (ESWT):
In this procedure, the doctor will send low to medium energy mechanical shocks to the affected part of the shoulder by the help of a handheld device. Shocks with a higher frequency are more effective, but they can be painful. Your doctor will adjust the shock waves to a level that you are comfortable with. This treatment may be performed once a week for three weeks.
3- Radial shock-wave therapy (RSWT):
Your doctor will send low to medium-energy mechanical shocks to the shoulder’s affected area by the help of a handheld device. This has similar results to ESWT.
4- Percutaneous needling:
This treatment is more invasive than other nonsurgical procedures. Your doctor will use a needle to make tiny holes in your skin after applying local anesthesia to the area. By doing this, they can manually remove the calcium deposit. This can be performed in combination with ultrasound to aid in the placement of the needle.
Most of the people can successfully treat calcific tendonitis without the need of surgery. However, around 10% of the people require surgery to remove the calcium deposits.
If your doctor chooses open surgery, they’ll make an incision in the skin directly above the deposit’s position using a scalpel. Then, the deposit would be manually removed.
If your doctor recommends arthroscopic surgery, a small incision will be made and a tiny camera will be inserted. The camera will guide the surgical tool in the removal of the calcium deposit.
The recovery period depends on the location, size, and a number of calcium deposits in the body. Some people recover completely within a week. Others may continue to have pain and discomfort, which restricts their movements and activities.
Calcific tendonitis is accompanied by severe pains and can even mobilize your shoulder. It is therefore imperative that you take good care of your shoulder. Avoid exercises that can cause shoulder impingement or worsen your already vulnerable shoulder. Try sleeping on your back and as it can distribute your weight evenly across the surface area of your back. Moreover, take a rest and follow the advice of your physician.
While some people may not feel any symptoms, calcific tendonitis may cause pain and discomfort and restrict the range of motion in other people. Pain medication and simple, quick procedures performed in a doctor’s office are used to treat majority of the cases. Surgery and physical therapy may be needed in more serious cases.
Calcific tendonitis can disappear without any treatment on its own. However, ignoring this condition is not a good idea because it can lead to complications, like frozen shoulder and rotator cuff tears.