What is calcific tendonitis?
Calcific tendonitis refers to the formation of calcium deposits on the rotator cuff tendons in the shoulder leading to painful tissue inflammation in the area. While the cause of the condition is unknown, there is an association with endocrine diseases such as thyroid gland disorders.
Women in the 30 to 60 age group are most at risk of developing this condition. It is a common condition and a study into 6000 office workers found 3% had calcium deposits in their tendons but only a third were symptomatic.
There are three stages of calcific tendonitis formative, when the deposits are created, resting and resorptive where the body removes the deposits.
While it is possible to have calcific tendonitis without any symptoms, pain in the front or back of your shoulder is common as is activity related pain. The pain is very similar to subacromial or shoulder impingement. In some cases, this pain may be severe enough to interfere with movement or sleep. Intense pain is most likely during the resorptive phase during which the calcium deposit disappears.
If you are experiencing shoulder pain that may indicate a development of calcific tendonitis, Dr Cheriachan will first perform a physical examination to determine your range of motion and level of pain. Then, in order to find signs of calcium deposits around the shoulder, you will often require an X-ray and ultrasound to identify the size of the calcium deposits and location. Seeing as calcific tendonitis can also be an incidental finding you may be sent to have an MRI scan to rule out other possible causes of your pain. Once the calcium deposits are detected and deemed the cause of your pain Dr Cheriachan will tailor a treatment plan to your condition.
There are many treatment options for calcific tendonitis with non-surgical options allowing for approximately 70% success in treating pain. Appropriate treatment depends on the severity of the pain. In less severe cases, your doctor may prescribe anti-inflammatory pain medication, corticosteroid injections, or physiotherapy to reduce the pain. Other more invasive options include extracorporeal shock wave therapy or therapeutic ultrasound with percutaneous needling. However, if non-surgical treatments prove ineffective for pain management, usually after 6 months of treatment, surgery may be appropriate for long-term pain relief. This is performed by arthroscopic or “Key hole” surgery to locate the deposits and remove them from the tendons.
In many cases, non-invasive treatments for calcific tendonitis yield positive results, allowing the patient to return to life and motion as usual within months. Should surgery be required, the recovery time is typically minimal. The arthroscopic method of surgery – a procedure in which your surgeon will make small incisions in the shoulder area and use a microscopic camera to see the treatment area – allows surgeons to minimise pain, blood loss, and recovery time.
Whilst the majority of people who undergo shoulder surgery do well and are very happy with their function and result, there are risks which are specific to shoulder surgery in addition to the general risks of surgery as listed in the FAQ section.
The specific risks with calcific tendonitis surgery is that in order to remove the deposit from within the tendon a tear may be created which needs to be repaired, also in the cases of small deposits it may be difficult to localise the deposit or not all of the calcium can be removed if there are multiple large deposits.
Dr Cheriachan will discuss with you in detail the risks of surgery during your consultation.
The process of recovering from calcific tendonitis can look different for each person, depending largely on the extent of the deposits and your response to non operative measures. Generally, physical therapy is the best method of speeding up rehabilitation, with a generally accepted stretching and range of motion program length of six to eight weeks. Typically most patients respond to non operative measures in 6 months.
If surgery is required, patients who have arthroscopic surgery without requiring a rotator cuff repair will recover quicker than those who do. If tendon repair is not required you will being physiotherpay and motion exercises immediately and use a sling for comfort only, In cases where rotator cuff repair is required, you will need to wear a sling for 6 weeks and full recovery may take three to four months or longer.
Preparing for your visit
Your first visit will be used to carefully assess your condition as well as gathering all related health information. It is important that you bring all relevant documents including scans and x-rays. We also ask that you wear clothing that allows freedom of movement as your visit will include a physical examination.