Have you ever suddenly experienced unbearable pain in your shoulder? Is it so severe that you can't even do simple things like lift your arm, change clothes, or comb your hair? Is the pain so severe that it even wakes you up at night? The cause of this is unknown to many, but it can be a very painful condition. That's what we're talking about today. In medical terms, we call this condition Calcific Tendonitis .
Simply put, what is Calcific Tendonitis?
Okay, let's put this simply. We have a strong tissue in our body that connects muscles and bones. This is what we call a tendon. Calcific Tendonitis is when calcium deposits form inside these tendons.
Think of it like limescale building up inside a water pipe over time. That's how calcium builds up inside these tendons. These calcium deposits can form in one place or in multiple places. As these grow larger, or become inflamed in some way, they can cause unbearable pain.
Although this condition can occur in any tendon in the body, it is most often seen in the shoulder . The tendon system in the shoulder is called the ``Rotator cuff``. So it is this ``Rotator cuff`` that is most affected.
Is this different from Rotator Cuff Tendonitis and Frozen Shoulder?
Yes, all three of these conditions are related to the shoulder, but they are different from each other.
- Rotator Cuff Tendonitis: This is an inflammation of the tendons in the shoulder. It can also cause swelling of the small fluid-filled sacs called bursae that help the tendons move. Calcific Tendonitis does not directly affect the bursa, but it can also cause them to swell due to calcium deposits.
- Frozen Shoulder: This is when the shoulder joint becomes frozen and stiff, preventing movement of the arm. Sometimes, a condition called Calcific Tendonitis can also cause `(Frozen shoulder)`.
Who is most likely to develop this condition?
People between the ages of 40 and 60 are most at risk of developing this condition. It has also been found to be slightly more common in women than men. However, it can occur in anyone. It is not associated with any specific activity or occupation.
But this is not a very common condition. Less than one in ten people seeking treatment for shoulder pain have this condition.
What are the stages of Calcific Tendonitis?
This condition occurs in three main stages. Understanding this will help you better understand the pain you are feeling.
| Stage | What happens at this stage |
|---|---|
| 1. Pre-calcific Stage | This is the initial stage. During this time, changes begin to occur at the cellular level in the tendon tissue. Pain occurs when the hand is moved, and the range of motion of the hand begins to be limited. |
| 2. Calcific Stage | It is during this stage that calcium is released from the cells, and those calcium deposits we mentioned begin to form. After a while, the body begins to resorb these deposits on its own. Many people feel the most severe pain during this period of resorption. |
| 3. Post-calcific Stage | This is the healing phase. During this time, healthy tendon tissue grows back where the calcium deposits were. Pain gradually decreases, and movement in the hand begins to return to normal. |
So is this a type of arthritis?
No. This is not a type of arthritis. The two are completely different.
Calcific Tendonitis is an inflammation of the tendons . But arthritis is an inflammation and damage of the joints . Sometimes this condition can be confused with a type of arthritis called calcium pyrophosphate dihydrate deposition disease (CPPD, or pseudogout). Because that also involves the deposition of calcium crystals inside the joints. But it's something different inside the joint. This happens inside the tendon.
What are the main symptoms of this condition?
Some people may have calcium deposits without any pain. However, if these deposits become inflamed, symptoms may develop.
- The sudden, unimaginable pain and stiffness in the shoulder .
- Severe pain when moving the shoulder.
- The pain increases to the point where you can't sleep at night .
- Difficulty doing things like lifting your arm or putting it behind your back, which means reduced range of motion .
- Pain that can be felt even when the rotator cuff area of the shoulder is touched.
How does a doctor diagnose this?
When you go to see your doctor, he will first ask you about your symptoms. Then he will examine your shoulder and see how far you can move your arm.
After that, you may be referred for some tests to confirm this condition and check for other medical conditions.
- X-ray examination: This is the easiest and most obvious way to check for calcium deposits in the tendons.
- Ultrasound scan: This can also help to check for calcium deposits and the condition of the tendons.
- MRI scan: Sometimes an MRI scan may be needed to further investigate tendon damage or other problems.
What are the treatments for this?
The good news is that most people with Calcific Tendonitis can recover without surgery . There are several treatment options.
| Treatment method | Simply put, what does it entail? |
|---|---|
| Painkillers and anti-inflammatory drugs (NSAIDs) | Medications like Ibuprofen and Naproxen can help control pain and swelling, but do not use these without medical advice. |
| Steroid Injections | If the pain and inflammation are severe, your doctor may give you a steroid injection directly into the shoulder joint. This can provide quick relief. |
| Physical Therapy | Once the pain has subsided, special exercises and treatments are performed under the supervision of a physical therapist to restore shoulder mobility and strength. |
| Shockwave Therapy (ESWT/RSWT) | This involves sending high-energy sound waves (shock waves) to break up calcium deposits, speeding up the healing process. |
| Lavage treatment | In this, the doctor, using an ultrasound machine, inserts two needles into the calcium lump. One needle injects saline solution while the other removes the dissolved calcium particles. |
| Therapeutic Ultrasound | A handheld device uses high-frequency sound waves to help break up calcium deposits. |
| Surgery | If no other treatment is successful, in the most severe cases, surgery is performed to remove these calcium deposits. However, this is only necessary for a small percentage of patients, about 10%. |
Can pain be controlled at home?
Yes, in addition to doctor's treatment, there are several things you can do at home to manage the pain.
- Rest: Rest your shoulder when it hurts. Avoid lifting heavy objects or doing overhead work.
- Hot and cold compresses: Some people find relief from hot water, while others find relief from ice packs. See what works best for you. But don't put ice directly on your skin, wrap it in a cloth.
- Painkillers as prescribed by your doctor: If your doctor has prescribed them, take painkillers in the prescribed dosage.
Important: If you experience sudden, severe pain in your shoulder, numbness in your arm, or if the pain does not subside within a few days, see your doctor without delay.
Can this pain come back?
Yes, sometimes symptoms of Calcific Tendonitis can recur. Some people can go months or even years without any problems before the pain returns. Therefore, if you have had this condition before, it is wise to see a doctor for regular checkups. In most cases, this condition can be cured quickly. However, it is essential to get a proper diagnosis and treatment.
Take-Home Message
- Calcific Tendonitis is a very painful condition caused by calcium deposits within the tendons of the shoulder.
- This is not a type of arthritis.
- The main symptom is sudden, severe shoulder pain that worsens at night and makes it impossible to move the arm.
- In most cases, this condition can be completely cured without surgery, with treatments such as injections, medications, and physical therapy.
- If you have any of these symptoms, don't ignore them. See your doctor as soon as possible for proper diagnosis and treatment.
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