Calcific tendonitis occurs when calcium deposits build up in the tendons and muscles of the rotator cuff. Calcium deposits can irritate the tendons and cause inflammation and severe pain. Patients are typically between 40 and 60 years of age. Women are more likely to be affected.
What causes calcific tendonitis?
Even though there are some theories, the cause of calcific tendonitis remains unclear. Conditions such as diabetes or thyroid disease have been implicated as risk factors.
Symptoms may include:
• Sudden shoulder pain at rest
• Intense shoulder pain during activity
• Pain that wakes you up in the middle of the night, disturbing your sleep
• Patients may be startled so much by the pain, so as to seek urgent medical attention
• Stiffness and reduced range of movement
Dr Panagopoulos will take a detailed history and perform a physical exam. X-rays are usually enough to confirm the diagnosis. Ultrasound may be useful to quantify the extent of the disease or used for ultrasound-guided needle lavage. MRI may help assess for concomitant pathology in cases of refractory pain.
Treatment typically begins with a trial of conservative management which may include:
• Rest
• Activity modification
• Physical therapy/home exercise program
• Steroid injection(s)
• Ultrasound-guided needle lavage or barbotage
If conservative management fails, surgery is the next step in treatment, with arthroscopic decompression of the calcific deposit. This is a day procedure. You can go home the same day if you wish. Surgery is performed arthroscopically. It involves finding the calcium deposit and scooping it out with arthroscopic instruments or a needle. It also typically includes a subacromial decompression or acromioplasty, which involves shaving-contouring your acromion to increase the space available underneath for your rotator cuff. Other shoulder problems, such as biceps tendon problems or cuff tears can be diagnosed and treated at the same time. Your arm will be placed in a sling for some time, based on the amount of arthroscopic work that was undertaken. You will start physical therapy. Recovery may take 6-8 weeks.
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