Shoulder pain can stop you in your tracks. When calcium deposits are the culprit, the condition is called calcific tendinitis. Although calcific tendinitis is a relatively common cause of shoulder pain, many people remain unaware of it until they experience it themselves. The pain often intensifies as the body begins to reabsorb the calcium, making an accurate diagnosis crucial for distinguishing calcific tendinitis from other injuries.
Summit Orthopedics specialists in the Minneapolis/St. Paul area provide the specialized imaging and clinical expertise needed to accurately determine the stage of your calcific tendinitis. Although it may not seem like it during a flare-up, this condition is entirely treatable. We are committed to guiding you through every step of the healing process.
What is Calcific Tendinitis?
Calcific tendinitis occurs when calcium deposits build up inside a tendon—often in the rotator cuff of the shoulder. The rotator cuff is a group of four muscles and their tendons that stabilize the shoulder joint and allow you to lift and rotate your arm. The supraspinatus tendon, which runs along the top of the shoulder, is the most commonly affected.
The condition affects less than 10% of adults and is slightly more common in women than in men. Most cases occur in people between ages 30 and 60.
One surprising detail: The more painful stage of calcific tendinitis isn’t usually when the calcium is building up—it’s when the body is reabsorbing it. During this phase, the calcium softens to a toothpaste-like consistency and can cause sudden, intense pain as your body works to break it down.
The 3 Stages of Calcific Tendinitis
Calcific tendinitis typically progresses through three distinct phases:
- Pre-calcific stage: Changes begin inside your shoulder, leading to pain with movement and a limited range of motion.
- Calcific stage: Tiny spots of calcium start to grow. As your body starts to break down these spots, they turn soft, like toothpaste. This can cause significant pain.
- Post-calcific stage: Your body finishes absorbing the calcium deposits. During this time, range of motion begins to improve.
What Causes Calcific Tendinitis?
Researchers don’t fully understand why calcium deposits form in tendons, but several factors may increase the risk:
- Being female
- Being over age 30
- Having diabetes or thyroid disease
- Repetitive overhead arm movements, whether at work or when playing sports
Symptoms of Calcific Tendinitis
Symptoms can range from mild to severe and may come on gradually or appear suddenly. Common signs include:
- Difficulty raising your arm overhead
- Pain that worsens at night or makes it hard to sleep
- Shoulder pain
- Stiffness and decreased range of motion in the shoulder
- Tenderness when pressing on the shoulder
In some cases, calcific tendinitis causes no symptoms at all and is discovered incidentally on an X-ray taken for another reason. In other cases, the pain can be severe enough to significantly limit daily activities.
When Should You See a Provider?
If shoulder pain lasts for more than a few weeks, interferes with sleep or limits your ability to move your arm normally, it’s worth getting checked out. Early diagnosis can help you get the right treatment sooner.
How Is Calcific Tendinitis Diagnosed?
Diagnosis typically begins with a physical exam. Your provider assesses your range of motion, applies targeted pressure to and stresses the rotator cuff, and reviews your medical history and activity level.
Imaging also plays an important role:
- X-rays can reveal the presence and location of calcium deposits.
- An MRI or diagnostic ultrasound can provide a more detailed picture of the tendons and help rule out other causes of shoulder pain, such as rotator cuff tears or shoulder arthritis.
Nonsurgical Treatment Options
- Rest and changes to activities
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen
- Physical therapy to restore strength, flexibility and range of motion
- Corticosteroid injections to reduce pain and inflammation
Minimally Invasive Procedures
When nonsurgical treatment isn’t providing enough relief, several office-based procedures can help remove the calcium deposits and reduce pain and inflammation in the tendon:
- Arthroscopic surgery: If symptoms haven’t improved after six to 12 months of nonsurgical care, the surgeon may recommend this minimally invasive procedure to remove the calcium deposits directly.
- Extracorporeal shockwave therapy (ESWT): This noninvasive treatment uses focused sound waves to break up calcium deposits.
- Lavage (barbotage): This ultrasound-guided procedure uses a needle to break up and flush out the calcium deposit.
- Platelet-rich plasma (PRP) injections: PRP uses a concentration of your own platelets to promote healing in the affected tendon.
What Happens if Calcific Tendinitis Is Left Untreated?
In many cases, the condition goes away on its own over time. However, without treatment, chronic pain and stiffness can linger. In some cases, the shoulder can develop a significant loss of range of motion (sometimes called frozen shoulder). That’s why early diagnosis and treatment, and following through on your care plan, matter.
Shoulder Care at Summit Orthopedics
At Summit Orthopedics, our shoulder specialists provide the highest standard of care for conditions like calcific tendinitis of the rotator cuff—from accurate diagnosis to a treatment plan tailored to your life and goals.
Summit Orthopedics surgeons are available at nearly 30 convenient locations across the Minneapolis/St. Paul metro area, serving Minnesota and western Wisconsin. Our state-of-the-art, comprehensive orthopedic centers offer same-day appointments from a team of experts who offer the full scope of orthopedic care.
Find a Summit Orthopedics shoulder specialist, request an appointment or call us at (651) 968-5201 to schedule a consultation.
