Calcific Tendonitis of the Shoulder

  • Definition

    Calcific tendonitis occurs when calcium deposits form in the tendons in the shoulder.
    Tendons of the Shoulder
    Rotator cuff labeled
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  • Causes

    Calcific tendonitis may be caused by:
    • Overuse, repetitive motions
    • Injury
  • Risk Factors

    Your risk of calcific tendonitis of the shoulder may be increased if you:
    • Participate in sports that require repetitive arm use such as baseball, swimming, javelin throwing, and volleyball
    • Have a job that requires repetitive arm use such as painting, carpentry, and welding
  • Symptoms

    Symptoms may include:
    • Sudden onset of pain
    • Intense pain with shoulder movement
    • Stiffness of shoulder
    • Loss of shoulder range of motion
    • Pain that disrupts sleep
    • Tenderness over rotator cuff
    • Loss of muscle mass
  • Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. It will assess your range of motion and stability.
    Images may be taken of your shoulder. This can be done with an x-ray.
    You may be referred to a specialist. For example, an orthopedic surgeon specializes in bones.
  • Treatment

    Most cases of calcific tendonitis resolve over time. Talk with your doctor about the best plan for you. Options include the following:
    Medical Treatment
    Your medical treatment plan will likely include:
    • Nonsteroidal antiinflammatory drugs (NSAIDs)
    • Rest
    • Heat and/or ice
    • Physical therapy to strengthen muscles
    • A steroid shot directly into your shoulder to decrease inflammation and pain
    Physical Therapy
    You may be referred to a therapist for treatment. A therapist will use different treatments to decrease the pain and inflammation. Possible treatments include:
    • Ultrasound—a device that uses high energy sound waves to decrease pain in soft tissue
    • Transcutaneous electrical nerve stimulation (TENS)—used to decrease muscle stiffness or spasms
    When the symptoms have started to decrease, you will work with the therapist to strengthen your muscles and increase your range of motion.
    Lavage Treatment
    Lavage may help flush out the calcium deposits. A needle is placed directly into the shoulder. Normal saline is injected through the needles. The deposits are then broken up for removal.
    Shock Wave Therapy
    This therapy breaks up deposits by sending sound waves to the shoulder. The body can then reabsorb the smaller pieces. This should decrease symptoms.
    Surgery
    In some cases, surgery may be done to remove deposits. The procedure is called arthroscopy . It uses small incisions and instruments to view the joint and remove the deposits.
  • Prevention

    To prevent this condition, avoid or limit repetitive movements of the upper arm.
  • RESOURCES

    American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

    Arthroscopy Association of North America http://www.aana.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org

    Canadian Orthopaedic Foundation http://www.canorth.org

    References

    Calcific tendonitis. Internet Society of Orthopaedic Surgery & Trauma website. Available at: http://www.orthogate.org/patient-education/shoulder/calcific-tendonitis-of-the-shoulder.html. Updated July 27, 2006. Accessed February 17, 2014.

    Calcific tendonitis. Orthopaedic & Sports Medicine Physicians website. Available at: http://www.orthosports.com.au/content%5Fcommon/pg-calcific-tendonitis.seo. Accessed February 17, 2014.

    Impingement of the shoulder. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00032. Updated February 2011. Accessed February 17, 2014.

    Impingement syndrome of rotator cuff. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 13, 2013. Accessed February 17, 2014.

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