Calcific tendinitis at a glance
What is calcific tendinitis of the shoulder?
Calcific tendinitis of the shoulder, known medically as tendinosis calcarea, is a condition in which calcium deposits form in the tendons of the rotator cuff. These deposits can cause considerable pain and restricted movement. It is characterised by episodes of intense pain that often come on suddenly and can seriously interfere with everyday activities. A visit to an orthopaedic specialist in Munich can clarify the best treatment strategy.
Key features:
- Definition: calcium deposits in the tendons of the rotator cuff
- Symptoms: intense pain, restricted movement
- Commonly affected: adults between 30 and 60 years of age
Causes of calcium deposits
The exact causes of calcium deposits forming are not yet fully understood. There are, however, several theories and risk factors associated with the development of calcific tendinitis:
- Circulatory problems: a poor blood supply to the tendons can impair cell activity and lead to calcium being deposited.
- Wear and tear: repeated loading and micro-injuries to the tendons can encourage calcium deposits.
- Metabolic disorders: changes in calcium metabolism may also play a role.
A specialist orthopaedic surgeon can help to identify the individual causes and risk factors and initiate appropriate treatment.
Risk factors:
- Circulatory problems – impaired cell activity due to poor blood supply
- Wear and tear – micro-injuries caused by repeated loading
- Metabolic disorders – changes in calcium metabolism
For more information on similar shoulder conditions, you can also read about shoulder pain and shoulder osteoarthritis.
Symptoms and diagnosis
Recognising and understanding the symptoms of calcific tendinitis is crucial for an early diagnosis and effective treatment. Calcific tendinitis, also known as tendinosis calcarea, can cause considerable discomfort and requires a careful medical examination to confirm the diagnosis.
Typical symptoms of calcific tendinitis
Calcific tendinitis can cause a variety of symptoms that may affect quality of life. The most common symptoms include:
- Pain: patients often report intense pain in the shoulder area that can radiate down the arm.
- Restricted movement: the mobility of the shoulder is often severely limited, making everyday activities difficult.
- Night pain: the pain often gets worse at night, leading to disturbed sleep.
- Tenderness: the shoulder can be very sensitive to pressure.
Frequency of common symptoms
- Shoulder pain: 90 per cent
- Restricted movement: 80 per cent
- Night pain: 70 per cent
- Tenderness: 60 per cent
Diagnosing calcific tendinitis
Calcific tendinitis is diagnosed through a combination of clinical examination and imaging. The following methods are used:
- Medical history: the doctor begins with a detailed conversation about the patient’s symptoms and medical background.
- Physical examination: assessment of shoulder mobility and palpation of the affected area.
- X-ray: crucial for confirming the diagnosis and demonstrating calcium deposits in the tendons.
- Ultrasound: helps to assess the soft tissue and detects possible inflammation.
- MRI (magnetic resonance imaging): can provide detailed images of the shoulder and rule out other causes of the pain.
For further information on shoulder conditions, visit our pages on shoulder pain, shoulder arthroscopy and shoulder osteoarthritis.
Treatment options
Conservative treatment approaches
Conservative treatment approaches play a crucial role in the management of calcific tendinitis. The aim of these approaches is to relieve pain and improve the mobility of the shoulder without resorting to invasive measures. The most common conservative treatments include:
- Rest and protection: reduces the load on the affected shoulder.
- Cold and heat therapy: relieves acute pain and inflammation.
- Physiotherapy: improves mobility and strengthens the muscles.
- Electrotherapy: promotes circulation and stimulates the healing process.
- Manual therapy: releases muscle tension and improves joint mobility.
Further information on conservative methods can be found in our article on shoulder pain.
Physiotherapy and exercises
Physiotherapy and targeted exercises are essential in the treatment of calcific tendinitis. They help to increase the mobility of the shoulder and strengthen the muscles. A physiotherapist puts together an individual exercise programme tailored specifically to the needs of the patient. Frequently used exercises include:
- Pendulum exercises: help to loosen the shoulder joint.
- Isometric exercises: strengthen the muscles without moving the joint.
- Stretching exercises: increase the flexibility of the affected shoulder.
These exercises should be carried out regularly and under the guidance of an experienced therapist in order to achieve optimal results. Further information on physiotherapeutic treatment can be found in our article on tendon therapy.
Medication
Medication is used to relieve pain and inflammation in calcific tendinitis. Commonly used medicines are:
- NSAIDs (non-steroidal anti-inflammatory drugs): reduce pain and inflammation.
- Corticosteroids: given as an injection directly into the affected shoulder, providing rapid relief.
- Painkillers: used for severe pain, to improve quality of life.
Overview:
- NSAIDs – effect: pain relief and reduction of inflammation; administered orally or topically
- Corticosteroids – effect: strong anti-inflammatory action; administered by injection
- Painkillers – effect: pain reduction; administered orally
It is important that medication is always taken under medical supervision, in order to avoid side effects and incorrect use. Further information on drug treatment can be found in our article on osteoarthritis therapy.
By combining conservative approaches, physiotherapy and medication, many patients can achieve a marked improvement in the symptoms of calcific tendinitis.
Invasive therapies
Depending on the severity and the response to conservative therapy, the treatment of calcific tendinitis may require invasive methods. These invasive therapies can offer effective solutions when other approaches have not been successful.
Shockwave therapy
Shockwave therapy is a non-invasive method used to treat calcium deposits in the shoulder. High-energy sound waves break up the calcium deposits and promote the healing of the tissue. An overview of the types of therapy can be found under radial and high-energy shockwave therapy.
- Radial shockwaves – 1–3 sessions per week; success rate 60–80 per cent
- High-energy shockwaves – 1–2 sessions per week; success rate 70–90 per cent
Minimally invasive procedures
Minimally invasive procedures such as arthroscopy are used when shockwave therapy does not have a sufficient effect. In shoulder arthroscopy, small instruments and a camera are introduced through small incisions in order to remove or break up the calcium deposits. This method has the advantage of faster recovery and fewer complications.
- Arthroscopy – recovery time 2–4 weeks; complication rate 5–10 per cent
Surgery as a last resort
If all other treatment options fail, open surgery may be necessary. This method is usually regarded as a last resort and is used for particularly stubborn calcium deposits or in severe cases. The operation is carried out under general anaesthetic and involves removing the calcium deposits as well as any reconstruction of damaged tendons.
- Open surgery – recovery time 6–12 weeks; success rate 80–95 per cent
Exploring these invasive therapies makes it possible to find the right treatment for calcific tendinitis. For detailed information on other orthopaedic procedures, please visit our sections on shoulder pain and shoulder surgery.
Long-term care and prevention
Rehabilitation measures
After treatment for calcific tendinitis, rehabilitation is crucial for supporting a full recovery and avoiding future problems. This includes specific physiotherapy exercises designed to restore the mobility and strength of the shoulder. Regular appointments with the physiotherapist and following a tailored exercise plan help to keep the shoulder in optimal condition. You can find further information in our sections on shoulder arthroscopy and tendon therapy, both of which can complement rehabilitation.
Nutrition and lifestyle
A balanced diet and a healthy lifestyle play an important role in recovering from and preventing calcific tendinitis. A diet rich in anti-inflammatory foods such as omega-3 fatty acids helps to reduce inflammation and promote healing. It is also important to take in enough vitamins and minerals, in particular calcium and vitamin D, to support bone health.
Nutrients that should be consumed regularly:
- Omega-3 fatty acids – reduction of inflammation
- Calcium – strengthening bone health
- Vitamin D – support for calcium absorption
Tips for preventing a recurrence
To avoid a recurrence, a few measures are worth highlighting:
- Regular exercise: light to moderate physical activity that strengthens the shoulder muscles and promotes their mobility can reduce the risk of calcium deposits.
- Ergonomic adjustments: pay attention to an ergonomic posture in everyday life, especially at work, to avoid unnecessary strain on the shoulder.
- Adequate fluid intake: drink enough water to support joint function optimally.
- Avoiding overload: protect your shoulder and avoid excessive loading or repetitive heavy work.
These preventive measures help to safeguard the health of the shoulder in the long term and prevent symptoms from returning. Further recommendations and specific tips can be found in our articles on shoulder pain and impingement syndrome treatment.
