Calcific Tendonitis

What is calcific tendonitis?

Calcific tendonitis is caused by calcium buildup in your tendons. These calcium deposits can accumulate in one area or may occur in more than one location. If the deposits grow bigger or become irritated, they can cause severe pain. Calcific tendonitis most often affects the shoulder — or rotator cuff — though it can occur anywhere in the body.

What’s the difference between calcific tendonitis and rotator cuff tendonitis?

Rotator cuff tendonitis — also called tendonosis — is associated with inflammation of bursae and damage of the shoulder tendon. A bursa is a thin, membrane-lined sack that helps the tendons move across other structures. Calcific tendonitis doesn’t affect bursae directly but the bursae can become inflamed.

Do I have calcific tendonitis or frozen shoulder?

While calcific tendonitis refers to the calcification of your tendons, frozen shoulder is a condition characterized by pain and stiffness. In some cases, calcific tendonitis is associated with frozen shoulder.

Who does calcific tendonitis affect?

People between the ages of 40 and 60 have a higher risk for calcific tendonitis. Women are also slightly more likely to be affected than men. Calcific tendonitis can happen to anyone and is not associated with any particular activity.

How common is calcific tendonitis?

Calcific tendonitis is not very common. The condition occurs in less than 10% of people being treated for shoulder pain.

How does calcific tendonitis affect my body?

Some people with calcific tendonitis don’t develop pain. However, if the calcium deposits in your tendons become inflamed, it can cause severe discomfort. For some patients, this eventually leads to pain and stiffness.

What are the stages of calcific tendonitis?

Calcific tendonitis occurs in three stages, including:

1. Pre-calcific: During this beginning phase, movement causes pain and range of motion becomes limited. The area changes at a cellular level.
2. Calcific: Calcium is released from cells, forming calcium deposits. After a time, the body begins resorbing the deposits. This stage can cause significant discomfort.
3. Post-calcific: During this stage, the deposits are replaced by healthy tissue. Range of motion begins to improve.

Is calcific tendonitis a form of arthritis?

No. Calcific tendonitis is inflammation of the tendons while arthritis is inflammation and damage of the joint itself. Calcific tendonitis may be confused with calcium pyrophosphate dihydrate deposition disease (CPPD, or pseudogout) — a type of arthritis in which calcium phosphate crystals form in the joints.

What causes calcific tendonitis?

Aging and wear and tear can eventually lead to calcific tendonitis. But healthcare experts really aren’t sure why some people develop the condition and others don’t.

What are the symptoms of calcific tendonitis?

People with calcific tendonitis may develop a number of different symptoms. These include:

• Sudden shoulder pain or stiffness.
• Intense pain with shoulder movement.
• Severe pain that disrupts sleep.
• Reduced range of motion.
• Rotator cuff tenderness.

How is calcific tendonitis diagnosed?

Your healthcare provider will examine your shoulder, ask about your symptoms and review your medical history. You may be referred to an orthopedic specialist for further testing.

What tests will be done to diagnose calcific tendonitis?

After checking your shoulder’s range of motion, your healthcare provider may order imaging tests. These may include:

• X-rays.
• Magnetic resonance imaging (MRI).
• Ultrasound.

What is the treatment for calcific tendonitis?

Most cases of calcific tendonitis can be treated with steroid injections, physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs). Other calcific tendonitis treatments include:

• Extracorporeal shockwave therapy (ESWT): This treatment delivers shock waves to the injured tendons to reduce pain and encourage healing.
• Radial shockwave therapy (RSWT): Similar to ESWT, RSWT also focuses on reducing pain and promoting healing. RSWT uses a different technique for generating shockwaves, but the two treatments yield the same results.
• Lavage treatment: During this treatment, your healthcare provider places a needle directly into the calcium deposit. Saline is then injected to break it up.
• Therapeutic ultrasound: Using a handheld device, your healthcare provider directs high frequency sound waves to the target area. This helps break down the calcium deposits.
• Surgery: In severe cases, surgery is necessary to manually remove the calcium deposits. Approximately 10% of people with calcific tendonitis need surgery.

Are there side effects of treatment?

Side effects depend on the treatment that is performed. Most non-surgical options have minimal side effects that may include temporary discomfort and swelling. Patients who undergo surgery for calcific tendonitis have a small risk of:

• Infection.
• A reaction to the general anesthesia.
• Frozen shoulder.

How long does it take to recover from calcific tendonitis surgery?

In most cases, recovery after calcific tendonitis surgery takes about six weeks. You may need to wear a sling to keep your shoulder from moving too much.

How can I manage calcific tendonitis symptoms at home?

Calcific tendonitis may be accompanied by mild or severe pain. You can manage most mild symptoms with:

• Rest.
• Heat and ice.
• Over-the-counter pain relievers, such as ibuprofen or naproxen sodium.

How can I reduce my risk for calcific tendonitis?

Though calcific tendonitis can’t be prevented altogether, there are steps you can take that may reduce your risk. For example, if you develop pain in your shoulder, don’t participate in any strenuous activities until you have it checked out by your healthcare provider.

What can I expect if I have calcific tendonitis?

Most of the time, calcific tendonitis can be addressed and resolved quickly. But periodic checks by your healthcare provider are recommended — especially if you’ve had the condition before.

Calcific tendonitis can also be associated with frozen shoulder or rotator cuff tears. If you have pain that doesn’t improve with treatment, be sure to let your healthcare provider know.

When should I see my healthcare provider?

If you experience sudden or intense shoulder pain, stiffness of your shoulder joint or discomfort that interrupts sleep, schedule a consultation with your healthcare provider. They can identify the root cause of your pain and determine an appropriate treatment plan.

Why is calcific tendonitis so painful?

Sometimes calcium deposits can lead to shoulder impingement syndrome. This occurs when the deposits cause your tendon to grow larger and it rubs against the bone. Many people also report significant pain during the reabsorption stage.

Will calcific tendonitis go away on its own?

In most cases, calcific tendonitis eventually goes away on its own. However, if you think you have calcific tendonitis, call your healthcare provider so they can rule out other issues.

Can calcific tendonitis come back?

Calcific tendonitis symptoms can wax and wane. Some people go months or years without experiencing issues. If you’ve had the condition in the past, it’s a good idea to schedule periodic checkups with your healthcare provider.

A note from Cleveland Clinic

Calcific tendonitis is usually resolved quickly. However, this condition can also be associated with other issues affecting the shoulder, such as bursitis, frozen shoulder and rotator cuff tendonitis. Therefore, if you develop calcific tendonitis symptoms, such as sudden pain, tenderness or reduced range of motion, contact your healthcare provider. Prompt diagnosis and treatment gives you the best chance for a quick, successful recovery.