Calcific Tendonitis

Calcific tendonitis of the shoulder happens when calcium deposits form on the tendons of your shoulder. The tissues around the deposit can become inflamed, causing a great deal of shoulder pain. This condition is fairly common. It most often affects people over the age of 40.

What is the causes of calcific tendonitis?
The cause of calcium deposits within the rotator cuff tendon is not entirely understood. Different ideas have been suggested, including blood supply and aging of the tendon, but the evidence to support these conclusions is not clear.

How does calcific tendonitis progress?
Calcific tendonitis usually progresses predictably, and almost always resolves eventually without surgery. The typical course is:

    • Precalcification Stage
      Patients usually do not have any symptoms in this stage. At this point in time, the site where the calcifications tend to develop undergo cellular changes that predispose the tissues to developing calcium deposits.

 

    • Calcific Stage
      During this stage, the calcium is excreted from cells and then coalesces into calcium deposits. When seen, the calcium looks chalky, it is not a solid piece of bone. Once the calcification has formed, a so-called resting phase begins, this is not a painful period and may last a varied length of time. After the resting phase, a resorptive phase begins–this is the most painful phase of calcific tendonitis. During this resorptive phase, the calcium deposit looks something like toothpaste.

 

  • Postcalcific Stage
    This is usually a painless stage as the calcium deposit disappears and is replaced by more normal appearing rotator cuff tendon.

Patients usually seek treatment during the painful resorptive phase of the calcific stage, but some patients have the deposits found incidentally as part of their evaluation impingement syndrome.

The Symptoms

The pain can be constant and nagging and is felt in the shoulder and outside of the upper arm, at times down the arm to the hand- aggravated by elevation of the arm. Night pain is often a feature and pain is intensified when raising the arm. In some instances the pain as well as tingling of the arm and fingers is experienced and may lead the treating physician think of the diagnosis of a nerve lesion of the neck.
Some patients experience attacks of excruciating pain, which then abate to a lower level after a few days.

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