Calcific Tendonitis of the Shoulder

What is Calcific Tendonitis of the Shoulder?

This is a condition that causes pain over the shoulder. It is caused by calcium being deposited in the tendons of the rotator cuff, which is a group of muscles that control shoulder movements. The condition can arise alone or can be associated with shoulder impingement. The latter occurs when bony outgrowths dig into the rotator cuff tendons causing pain. Sometimes these calcium deposits cause little or no pain, but in other cases the condition can be very painful.

How is it diagnosed?

Diagnosis by a specialist is usually straightforward, and X-rays are usually may be performedto show the deposits and to confirm the diagnosis. In some cases an ultrasound scan may be performed to confirm the diagnosis.

How is Calcific Tendonitis of the Shoulder Treated?

Treatment starts with simple measures, and these are often effective. Anti-inflammatory tablets and painkillers can help symptoms. Physiotherapy exercises are important in preventing the shoulder becoming stiff through restricted use because of the pain.  Muscle strengthening, usually under the guidance of a physiotherapist can also help.  Avoiding repetitive movements and correct warming-up and stretching techniques can also help.

What is the role of Shock Wave Therapy?

Sometimes the condition does not respond to these simple measures and the pain becomes longstanding (chronic).  In these cases other treatments are considered.  These treatments can be divided into non-surgical treatments (low energy shock wave therapy) and surgical treatments (needling and excision of calcium deposits).

Shock wave therapy is the most effective next step if simple measure do not help as it is often successful and is non-invasive (no needles or surgery) being performed in the outpatient clinic without the need for any anaesthetic.  It is also very safe. Our results show that 70% of people with Calcific Tendonitis of the Shoulder condition are successfully treated and therefore saved from having surgery.

Needling is performed under a brief general anaesthetic or sometimes under local anaesthetic with sedation.  It involves directing a needle into the calcium deposit and trying to aspirate (suck) it out to relieve the pain.  At the same time, a steroid injection is usually performed.

Excision of the deposit is a procedure performed under general anaesthetic usually through key-hole surgery.