What is Calcification Tendinitis?
Calcification tendinitis is a problem with the shoulder’s tendons and muscles. This condition occurs due to the formation of calcium deposits in the tendons (tissue which attaches muscle to bone) of the rotator cuff (a group of muscles and tendons stabilizing the shoulder). This calcium build-up causes inflammation of the tissues surrounding it, and intense shoulder pain. The space between the rotator cuff and the acromion (outer bony end of the shoulder blade) is also reduced due to the calcium deposits, affecting the normal functioning of the rotator cuff.
The deposits often occur in people above 30-40 years old and are more common in diabetic patients.
Symptoms of Calcification Tendinitis
- Pre-calcification stage: This is the beginning of calcium formation where changes happen in the cells and you may not experience any symptoms.
- Calcific stage: The cells release calcium, which combines to form calcium deposits. This stage generally lasts for a varied period of time without any pain and is called the resting phase. The most painful phase called the resorptive phase begins after the resting phase. Most patients seek treatment during this phase due to the severe pain associated with this stage.
- Post-calcific stage: The calcium deposition starts being replaced with a normal rotator cuff tendon. This stage is usually painless.
Causes of Calcification Tendinitis
Diagnosis of Calcification Tendinitis
Treatment of Calcification Tendinitis
- Anti-Inflammatory medications: The pain associated with calcific deposits can be treated with anti-inflammatory medications.
- Steroid injections: If you experience severe pain, steroid injections may be administered to relieve pain, swelling, and inflammation.
- Lavage procedure: In order to control the severe pain during the resorptive stage, your doctor may suggest a procedure called lavage. Your doctor will insert two large needles into the shoulder joint to flush the calcium deposits with saline solution (salt solution) repeatedly to loosen them. After they loosen, the deposits are then aspirated or sucked out through the needle.
- Heat/ice application: A washcloth dipped in warm or an ice water can be placed on the affected shoulder to relieve pain.
- Shock wave therapy: This therapy is administered once a week for up to 3 weeks. Your therapist will generate pulses of shock waves on the affected area to break the calcium deposits so that they can be easily absorbed by the body.
- Arthroscopic surgery: Your surgeon will make a small incision and insert an arthroscope (lighted camera) into the shoulder joint. Calcium deposits will be located in the rotator cuff tendon using the arthroscope, then the deposits are removed with tiny surgical tools and the area is rinsed with saline solution.
- Open surgery: In very rare cases, your surgeon will cut through the skin, muscles and the surrounding tissues to remove the calcium deposits. The area will be rinsed to remove the remaining calcium crystals. The muscles and skin will then be stitched together to close the incision.