Calcific tendonitis is one of the most painful shoulder conditions.  No one knows what causes the calcium to deposit inside your rotator cuff.  If you have very severe shoulder pain and you were told that you have extra calcium on your shoulder X-ray then you are likely suffering from calcific tendonitis of the rotator cuff.   You have a few successful non-surgical and surgical options to treat the calcium in your rotator cuff.

 

What is Calcific tendonitis ?

Calcific Tendonitis is a condition where calcium is actually found inside the rotator cuff tendon itself. The calcium causes pressure within the rotator cuff.  You body will try and reabsorb and remove the calcium.  When it does so, it sets off a chemical cascade that can lead to very profound inflammation.

Calcific tendonitis of the rotator cuff usually causes profound pain.  For some, the pain is mild— for many, the pain can be very severe. The pain is usually on the top or side of your shoulder –because that is the most common location for a calcium deposit in your shoulder. Calcific tendonitis of the rotator cuff is common in people between the ages of 40-65.

Note the comma shaped calcium deposit above the humerus

Why Do I Have Calcium in My Shoulder?

We do not know why most people develop calcium deposits in their shoulder.  It does not mean you are drinking too much milk or taking too many calcium supplements.

 

How Do You Treat Calcium in The Shoulder?

Calcific tendonitis can be extremely painful.  While some patients can have mild symptoms, most patients are miserable and are looking for a “quick fix”.   Patients with calcific tendonitis are usually easy to pick out of a crowd of shoulder pain patients. They look tired from not sleeping, they can not sit still and they are always grabbing their shoulder.

Shoulder ice/compression sleeves can help when the pain of calcific tendonitis is severe. If the pain is tolerable then it is  OK to pursue a course of “observation.” Many cases of calcific tendonitis will resolve spontaneously. Yes.. in many, the calcium will dissolve and go away. It might take years to do so, but the calcium will dissolve away in most patients.

If, however,  your pain is very severe, the most effective way to alleviate your pain is for us to send you to a radiologist who will perform an ultrasound.  After the Radiologist identifies the calcium deposit in your rotator cuff, they will place a needle into the calcium deposit and “wash it out.”  The relief is usually immediate and profound. Again, consider a cold compression sleeve for the first few days after the procedure.  In the majority of people the calcium deposit has the feel of toothpaste.  It is usually not a hard deposit like bone.

Do I Need Surgery For Calcium in my Rotator Cuff?

Because the ultrasound guided washout has been so successful, it is very rare that surgery for calcific tendonitis is necessary. The key is to find a surgeon / radiologist team that works together and is very good at this technique.   The ultrasound guided washout is a small procedure performed in the office.  It is performed using local anesthesia in your skin.   You will be sore for a day or two after the washout, then your pain should subside dramatically.

On occasion the calcium which was washed out of the rotator cuff will cause an intense bursitis, or inflammation within the shoulder.  If this happens, and you do not respond to ice and anti-inflammatories then there is a chance that you will require keyhole or arthroscopic surgery to remove the inflamed tissue.  This is a very rare instance.