CALCIFIC TENDINITIS: TYPES, SYMPTOMS, DIAGNOSIS, AND TREATMENT
Calcific tendinitis occurs when calcium crystals build in your tendons. The irritation from the calcium deposits causes inflammation and pain.
Most cases of calcific tendinopathy occur in the shoulder, but it can affect any part of your body. The exact cause of calcification or calcium build-up in joints is still not completely clear. However, certain risk factors, like age, gender, and underlying disease, increase your chances of developing calcific tendinitis.
Calcific tendinopathy is usually relieved with medication, physical therapy, and other non-surgical treatments. But when left untreated, severe calcific tendinitis can affect your range of motion and require surgical treatment.
Keep reading to learn more about calcific tendonitis, its symptoms, and its various treatment options.
Calcific Tendonitis, Calcific Tendinitis, or Calcific Tendinopathy. It’s a painful condition that occurs when calcium deposits build up in your muscles and tendons.
Although it can occur anywhere in your body, it most often affects the rotator cuff in your shoulder. Your rotator cuff is a group of muscles and their tendons covering your shoulder joint.
The calcium deposit initially accumulates in one portion of your joint. When this calcific deposit continues to build, it can irritate your tendons and cause inflammation. If it progresses, calcific tendinitis can lead to severe pains and loss of joint function.
Calcific tendinopathy is often confused with other conditions affecting the shoulder, such as Frozen Shoulder and Rotator Cuff Tendinitis. They may be associated with each other but are still different conditions.
Frozen shoulder is an inflammatory condition that develops when your shoulder has been immobile for too long, leading to a stiff and painful shoulder. A frozen shoulder generally does not involve calcification.
Although both conditions can cause inflammation to your rotator cuff tendons, rotator cuff tendinitis primarily affects the bursa of your shoulder joint. The bursa is a membranous sac that cushions your tendons and bones. Calcific tendonitis rarely affects your shoulder joint bursa.
Regenerative calcific tendinopathy is also known as Reactive Calcification. Reactive calcification is the formation of calcium crystals in tissues; however, the cause is still unclear.
It occurs in three stages of calcification:
- Pre-calcific stage: The initial phase of reactive calcific tendinitis involves the build-up of calcium deposits on tissues. Patients in this stage typically show no symptoms.
- Calcific stage: The cells release calcium, which is then absorbed by your body in the calcific stage. Patients in this stage may experience swelling and discomfort or pain.
- Post-calcific stage: This is the least painful stage when the calcium deposits disappear and you regain a normal range of motions in your joint.
Degenerative calcification occurs with aging. As you age, the blood flow to your muscles and tendons is reduced, weakening them. Aside from that, gradual wear and tear can lead your muscles to fray.
As the damaged fibers heal, calcium deposition can occur on the tissues, leading to degenerative calcification.
Patients with calcific tendinopathy typically experience discomfort in the affected area. But not everyone may experience the same symptoms, and even entirely possible to have no signs of calcific tendinitis.
Depending on the stage of calcification, you may experience the following symptoms of calcific tendinitis:
- Severe pain in the shoulders
- Shoulder stiffness
- Pain with joint movement
- Tenderness of your rotator cuff muscles
- Reduced range of motion
- Atrophy or loss of muscle mass
Symptoms of calcific tendinopathy are common among other joint conditions. If you are experiencing severe pain or your condition is limiting your movement, contact your healthcare provider as soon as possible.
The exact cause of calcific tendinopathy has yet to be determined.
The degeneration that comes with aging can lead to the development of calcific tendonitis. General wear and tear of the tendons in your shoulder joint, knee joint, elbows, or wrists can trigger calcification.
When your tendons are damaged, it stimulates your tissue repair system, making them susceptible to the build-up of calcium deposits in your tendon.
Calcific tendonitis is not a common condition, nor is it associated with a specific activity. Certain factors may increase your risk of developing calcific tendinopathy.
- Age 40 and above
- Genetic factors
- Sex, calcific tendonitis is more common in females
- Metabolic diseases, like diabetes
- Abnormal thyroid gland activity
To diagnose calcific tendinopathy, your healthcare provider reviews your medical history and performs a physical exam to assess your symptoms.
Your doctor may request imaging tests to confirm calcific tendinopathy:
- X-rays: X-rays allow your doctor to view larger calcium deposits.
- Ultrasound: An ultrasound offers a better view of small groups of calcific deposits than an X-ray. It also allows them to determine the size of deposits.
- Magnetic Resonance Imaging (MRI): Although not essential, an MRI can show calcium deposits, especially for chronic calcific tendinitis.
Determining the amount and size of calcium build-up allows your healthcare provider to decide the best treatment option for you. They may also refer you to an orthopedic specialist for further investigation into your condition.
Conservative treatment is usually the initial treatment for mild cases of calcific tendinitis. Depending on the extent of your calcific tendinopathy, your doctor may recommend a combination of non-surgical approaches.
Your doctor may prescribe Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) to help relieve pain and reduce the inflammation of calcific tendonitis. Anti-inflammatory medicines are usually the first treatments applied, including:
Your doctor may also recommend corticosteroid injections. Commonly known as steroid injection or cortisone injection, these anti-inflammatory medications help with swelling and pain.
Physical therapy for calcific tendonitis is the preferred non-invasive treatment to relieve painful symptoms and strengthen your muscles and tendons.
Your physical therapist creates a treatment plan that includes various approaches to manage your calcific tendonitis.
- Heat therapy
- Ice packs
- Transcutaneous electrical nerve stimulation
- Range of motion exercises
- Stretching and strengthening exercises
For mild-to-moderate cases of calcific tendinopathy, your doctor may suggest alternative non-surgical treatments.
These conservative approaches are minimally invasive or non-invasive treatments that trigger physiological reactions in your body. These reactions boost your natural healing mechanism for tissue healing and pain relief.
Alternative treatment of calcific tendinitis may include:
- Radial Shockwave therapy
- Extracorporeal shock wave therapy
- Therapeutic ultrasound
- Percutaneous needling
Surgical treatment for calcific tendinopathy is reserved for severe cases.
The standard surgical procedure for calcific tendinopathy is arthroscopic surgery. Your surgeon creates small incisions and inserts an arthroscope, a lighted instrument, into your joint to remove the calcium deposits.
Recovery after the surgery depends on the number, location, and size of the calcium deposits in your joints. Your surgeon may prescribe physical therapy to help you regain a full range of motion in your joint.
As with every surgical procedure, there are risks of developing complications from arthroscopic surgery for calcific tendonitis. Although rare, these complications of surgery may include:
- Frozen shoulders
- Reaction to anesthesia
Most cases of calcific tendinitis can be easily treated with rest and conservative treatment. Surgery for severe calcific tendinopathy may take some recovery time, but you’ll be able to regain joint function and resume your daily activities within the week of the surgery.
Regular check-ups with your healthcare providers are essential when recovering from calcific tendinitis, especially if you have had a previous experience of calcific tendinopathies.
Although calcific tendinitis can be associated with rotator cuff tendonitis and frozen shoulder, you may have a greater chance of full recovery when treated early on.
How long does it take for calcific tendonitis to heal?
Although the calcium deposits gradually dissolve spontaneously, a full recovery from calcific tendonitis may take about 12 to 18 months to heal.
Why is calcific tendonitis painful?
Calcific tendinitis occurs with the deposition of calcium in your tendons. The calcium build-up adds pressure and irritates the tendons, causing inflammation and chronic pain.
What is the best treatment option for calcium tendonitis?
There is no single cure for calcific tendinopathy. Conservative treatments, like physical therapy or medications, for calcific tendinitis usually relieve mild cases. For severe symptoms, you may need to resort to surgical treatment for tendinitis.
Is calcific tendonitis serious?
Calcific tendinitis is a build-up of calcium deposits in your tendons, causing inflammation and pain. If left untreated, it can lead to severely impaired movement and reduced quality of life.
What causes calcific tendinitis?
The exact cause of calcific tendinopathy is still unclear. However, degeneration with aging and general wear and tear can trigger calcification in tendons.
Can too much consumption of calcium lead to calcium tendonitis?
Consuming excess amounts of calcium does not contribute to calcific tendonitis. Calcium in your diet is essential to reduce your chances of developing bone problems like osteoporosis or bone thinning.
Is calcific tendinitis surgery risky?
Surgery for calcific tendinopathy is safe, but there is a low risk of developing side effects from surgery like all other surgical procedures.
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- Calcific tendinitis of the rotator cuff: state-of-the-art in diagnosis and treatment
- Arthroscopic Treatment of Calcific Tendonitis
- Effectiveness of radial shock-wave therapy for calcific tendinitis of the shoulder: a single-blind, randomized clinical study
- Calcium deposits in the shoulder and subacromial bursitis: a survey of 12,122 shoulders
- Prognostic factors in nonoperative therapy for chronic symptomatic calcific tendinitis of the shoulder
- Calcifying Tendinitis Treatment & Management - Medscape
- What Are Calcium Deposits on Tendons?
- Calcific Tendinitis of the Rotator Cuff: A Review
- Calcific tendinitis of the shoulder
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