Calcific tendinitis of the shoulder is a painful condition caused by the deposition of calcium crystals within the tendons of the rotator cuff, most commonly the supraspinatus tendon. While the exact cause is not fully understood, it is often seen in middle-aged individuals and can lead to significant pain, stiffness, and reduced mobility.
we received a 45 years old female patient in our OPD in indore , with pain in shoulder. She has history of trauma and injury 1 year back. Eventually she developed calcific tendinitis of Supraspinatus tendon.
As an orthopedic specialist, I often encounter patients struggling with shoulder discomfort that has not responded to typical rest and physiotherapy. In many cases, further imaging like X-rays or MRI reveals calcium deposits as the culprit. Here’s how we approach the treatment of this condition in a structured and effective manner.
Understanding the Condition
Calcific tendinitis typically progresses through three stages:
- Formative Phase: Calcium deposits begin forming in the tendon.
- Resting Phase: The deposits remain relatively stable but can still cause pain and limited movement.
- Resorptive Phase: The body attempts to reabsorb the calcium, which can trigger intense pain and inflammation.
Early diagnosis is essential to guide appropriate treatment and prevent chronic disability.
Treatment Options
Treatment of calcific tendinitis focuses on relieving pain, reducing inflammation, and restoring function. The choice of treatment depends on the stage of the condition and the severity of symptoms.
1. Conservative (Non-Surgical) Treatment
Most cases respond well to non-operative management:
- Rest and Activity Modification: Avoiding movements that exacerbate the pain, especially overhead activities.
- Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac help reduce pain and inflammation.
- Physiotherapy: A tailored rehabilitation program focusing on gentle range-of-motion and strengthening exercises.
- Cold or Heat Therapy: Applying ice during acute pain and heat during stiffness phases can be beneficial.
2. Ultrasound-Guided Needling (Barbotage)
This minimally invasive procedure involves:
- Using ultrasound to precisely locate the calcium deposit.
- Inserting a needle to break up the deposit and aspirate (suction) it out.
- Sometimes followed by a corticosteroid injection to reduce inflammation.
This technique offers rapid relief and has high success rates with minimal downtime.
3. Extracorporeal Shock Wave Therapy (ESWT)
ESWT uses focused sound waves to break down the calcium deposits and stimulate healing. It’s typically done in multiple sessions and is useful for patients who don’t respond to initial treatments.
4. Corticosteroid Injections
In cases of persistent pain and inflammation, corticosteroid injections may be administered directly into the subacromial space to provide temporary relief. These are especially helpful during the resorptive phase.
5. Surgical Intervention
Surgery is considered only if conservative treatments fail after 6 months or more:
- Arthroscopic Removal: A keyhole surgical procedure to remove calcium deposits and, if necessary, repair the tendon.
- Open Surgery: Rarely required, typically for very large or chronic deposits.
Post-surgery rehabilitation is crucial for full recovery and return to normal shoulder function.
Prognosis and Recovery
With appropriate treatment, most patients recover well from calcific tendinitis. Early diagnosis and a structured management plan are key to preventing complications and recurrence. Patient education, compliance with physiotherapy, and follow-up care ensure the best outcomes.
Conclusion
Calcific tendinitis of the shoulder, though painful, is a treatable condition. At my practice, we focus on individualized care, accurate diagnosis through imaging, and a stepwise treatment approach — starting from conservative methods and escalating only when necessary. Minimally invasive options like ultrasound-guided needling have revolutionized treatment, allowing faster recovery and reduced patient discomfort.
If you’re struggling with persistent shoulder pain or limited mobility, don’t ignore it. Timely evaluation and expert care can make all the difference.
To book an appointment or learn more:
📍 Dr. Anupam Khandelwal – Joint Replacement & Orthopedic Clinic, Indore
📞 Phone: +91-8818814030 , +91-7880001778
🌐 Website: www.dranupamkhandelwal.com