If you or someone you know is experiencing shoulder pain, discomfort, or immobility of any degree, one of the differential diagnoses has to include calcification of the tendon or tendons of the shoulder girdle. Why? Because Calcific Tendonitis happens to be the leading cause of chronic shoulder pain.
The shoulder, a unique ball & socket joint, is quite a mobile region of the body, however, it also happens to be one of the most vulnerable to injury. The price for a highly mobile joint is that it can also be quite the unstable joint. Four main muscle groups called the Rotator Cuff are the main anchors holding that very mobile joint, together with a strong fibrous ring called the labrum. Think of the labrum as a tight “O” ring of tissue that holds the ball into the socket of the shoulder joint. When any of these tissues are compromised, the result is typically debilitation to some degree. Usually beginning with pain.
One of the causes of this debilitation, immobility, and pain is a shoulder condition known as calcific tendonitis; a condition involving a build-up of calcium phosphate crystals in the tendons of the shoulder joint, particularly in the tendons and muscles of the rotator cuff muscles. For obvious reasons, this causes immobility, pain, and weakness of the affected shoulder joint. Simple actions like putting on a bra or a shirt can be quite painful and difficult.
In what follows, we’ll be discussing what calcific tendonitis is, specifically of the shoulder, though it can occur anywhere else in the body. In addition, we’ll be discussing the causes, symptoms, and available treatments of calcific tendonitis.
If you or someone you know happens to be experiencing any or all of the symptoms discussed throughout this article, it’s imperative that you consult with your doctor or chiropractor in West Vancouver at Ambleside Chiropractic as soon as possible. We are always here to help.
While the best medicine is prevention, there are treatments available for this debilitating condition. You might be surprised to find out that one of the most effective treatment options is actually non-invasive and has more than an 80 percent success rate.
Let’s get into it…First, what is calcific tendonitis of the shoulder?!
What is Calcific Tendonitis?
In short, calcific tendonitis is a condition involving a deposit or build-up of calcium crystals surrounding the rotator cuff and tendons of the shoulder. The result is immobility, pain, stiffness, and weakness primarily. The simple activities of daily living such as house chores, driving, or even working on a computer can be very painful and debilitating.
While the causes of calcific tendonitis are largely unknown, there are associated risk factors involved with its diagnosis, including but not limited to age, health status, and sex.
Other risk factors include heavy lifting with poor technique, excessive use of overhead motion, sports involving overuse of the shoulders (i.e. tennis, badminton, etc) and more than not, repetitive use of the shoulder joint either because of a job or activity. An accident or shoulder injury can also contribute to Calcific Tendonitis at a later stage even after the initial injury has healed.
Causes of Calcific Tendonitis of the Shoulder
As mentioned, although the cause(s) of calcification of the tendon is still widely unknown, certain risk factors are strongly correlated with its diagnosis. If you’re a female aged 40-60, research suggests that you’re most at risk.
With that said, this shoulder condition can happen to anyone. Moreover, calcific tendonitis can compromise other joints and body areas as well. In other words, the condition isn’t exclusive to just the shoulder joint.
Other causes and risk factors of calcific tendonitis are:
- Genetic Inheritance
- Aging
- Repetitive shoulder movements from a job or sports
- Accidents and injury
- Diabetes and other Metabolic Diseases
- Thyroid Disease
- Lifestyle Factors
Another common cause could be that the deposition of calcium in the tendons is a result of a previous injury that might have included a minor tear or bleeding of the muscle and associated tendon. When the initial injury has healed, the calcium that is normally in the blood remains and crystallizes within the tendon. Unless there is a direct intervention to remove it, it generally remains there forever.
If the causes of calcific tendonitis result in larger deposits and growths, symptoms will only become more severe. That’s why it’s imperative to consult with a professional as soon as symptoms become apparent.
Symptoms of Calcific Tendonitis of the Shoulder
While a small percentage of those that suffer from calcific tendonitis have no apparent symptoms, the majority of them do. Symptoms of this condition are easily recognizable because, well, pain and an inability to move the shoulder and arm are hard to ignore.
Below are the most apparent symptoms of shoulder calcific tendonitis:
- Shooting Pain and Discomfort
- Lack of Range of Motion (ROM) and Flexibility
- Total Loss of Shoulder Mobility
- Stiffness, Tightness, and Tenderness
- Loss of Muscle/Weakness of Muscle
Because it can take months, if not years, for calcification to develop and progress, symptoms too can be long-lasting, especially if not taken care of in a timely fashion. Nevertheless, the good news is that there are treatments available to mediate, manage, and relieve symptoms. They range from pain management to the total removal of calcium deposits.
How to Treat Calcific Tendonitis
You’ll be happy to read that the majority of cases of calcific tendonitis can be treated without surgery, though severe cases may require it…
Treatment for this condition is typically a multi-faceted approach, involving a combination of several treatments at once. With a conservative approach to treatment, success rates range from 30%-80+%.
The following are the most common treatments of calcific tendonitis of the shoulder:
- Prescription Pain Medication non-steroidal anti-inflammatories)
- Over-the-Counter Medication (aspirin, ibuprofen, etc.)
- Extracorporeal Shockwave Therapy (ESWT)
- Physical therapy modalities such as ultrasound and dry needling
- Surgical Procedures such as Barbotage (invasive)
- Rehabilitative Methods (physical therapy, chiropractic care, manual self-care)
- Rest and Recovery
- Ice and heat
Depending on the severity and length of time symptoms have been experienced, determining the course of treatment will vary and will likely involve a multitude of treatments at once or singularly.
Generally speaking, treatment will likely take upwards of two months or more depending on the severity and necessity of care. This is, of course, if treatment is followed properly and consistently. Consistency in treatment protocols is the key to a successful outcome.
Once treatment has concluded, it’s important to continue with physical health practices both for prevention and proactive insurance. Be mindful that the best form of post-treatment activities is prevention. Make sure to either change the way you work, play or live in order to prevent this condition from returning.
Extracorporeal Shockwave Therapy (ESWT)
As a Chiropractor in West Vancouver, I have had a lot of success in treating Calcific Tendonitis using Extracorporeal Shockwave Therapy (ESWT). The noted success rate of treating Calcific Tendonitis is over 80% based on studies and actual clinical data. Depending on the severity and amount of time the patient has been diagnosed will determine the length and number of sessions required. The procedure is non-invasive and not painful. Although there might be some residual soreness and redness after the first few treatments. These symptoms are temporary and do not cause a great deal of discomfort. Most times it will last only a few hours.
I typically start with either an X-ray or ultrasound to determine the location and size of the crystal deposit. This helps to target the treatment area directly. Corroborating this with a radiologist report is also very helpful. Treatments are usually 15 to 20 minutes and initially twice a week but then once a week thereafter. Most patients will report no pain and improved mobility within a month or two. It’s important to note that it could take the body 6-8 months to reabsorb the calcium back into the bloodstream but the patient should be pain-free and able to go about their activities of daily living and sport a lot sooner. The majority of calcific tendonitis is found in one of the rotator cuff muscles called the Supraspinatus. For more detailed information on what Calcific Tendonitis is and also what Extracorporeal Shockwave Therapy (ESWT) is, Click Here to find out more.
Final Outlook
The solution for calcific tendonitis can be a simple, quick, and effective option, making the outlook for those suffering from it an optimistic one. With less than 10% of cases needing surgery, and a large minority not even experiencing major symptoms, calcific tendonitis of the shoulder is easily treatable.
With that said, like all injuries and physical conditions, if ignored, it can lead to greater complications and longer-lasting symptoms, among other consequences.
In summary, while calcific tendonitis can be painful for some, and a debilitating process for even fewer, this condition does carry a positive long-term outlook, with no evidence suggesting a recurrence once healed.
If you’re interested in consulting with an experienced chiropractor for rehabilitation and preventative purposes and you’re in the Vancouver area, contact us at Ambleside Chiropractic Clinic in West Vancouver. We are always happy to help! Simply give us a call and we’ll ensure that you are booked in for at least a consultation with our chiropractor in West Vancouver.
