Calcific Tendonitis Shoulder Treatment

Calcific tendonitis is a painful disorder where there is a build up of calcium deposits in your rotator cuff tendons. While calcific tendonitis shoulder treatment strategies vary depending on the severity of the issue, physiotherapy is a great first port of call to help understand your injury and develop a tailored management and treatment plan.

UNDERSTANDING CALCIFIC TENDONITIS

The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, teres minor and subscapularis) that come together as tendons to encapsulate the shoulder joint providing it with dynamic stability.

There are several different varieties of calcification in the shoulder which are unique conditions not associated with calcific tendonitis shoulder problems. An example is the build up of calcium deposits following a rotator cuff tear (dystrophic calcification) and the formation of calcium deposits in arthritis. This form of calcification is quite different to true calcific tendonitis.

The most commonly affected tendon in those experiencing a calcific tendonitis shoulder is the supraspinatus tendon (approximately 50-90%) with the subscapularis tendon being the least commonly affected (approximately 3%).

If you require more information, or are interested in meaningful calcific tendonitis shoulder treatment, trust the skilled physiotherapist team from Pivotal Motion. Book an appointment online, or feel free to call us on 07 3352 5116.

1. The Pre-calcific phase: This is the earliest phase and is usually asymptomatic. In this stage, there is a transformation within the tendon at a cellular level.
2. The Formative phase: This is the start of the deposition of chalk-like calcium deposits within the tendon. Stage 2 may be asymptomatic.  During this stage there is a frequent occurrence of intermittent pain, usually related to movement.
3. The Resorptive phase: At this stage, the most painful process of all occurs – the tendon begins to heal. The resorptive phase occurs with an increase of inflammatory markers in the area.  The markers assist with re-absorbing the calcium deposits which are now toothpaste like in texture. On some rare occasions, some of the calcium deposits infiltrate into a fluid filled, shock absorbing structure known as the subacromial bursa. Constant pain, fever and malaise will occur.
4. The Post-calcifying phase: The tendon properties return to “normal”. The post-calcifying stage is associated with some pain and stiffness in the joint.

The diagnosis of calcific tendonitits condition is usually based on a comprehensive history from the patient, a thorough physical examination and a plain x-ray.

Following a diagnosis, the treatment regime will begin according to the severity. In most cases, conservative treatment in the form of non-steroidal anti-inflammatory drugs and physiotherapy is the first port of call.

Physiotherapy includes a correction of shoulder biomechanics, manual therapy, self management advice and specific exercises for the rotator cuff tendons. There is conflicting evidence for the use of ultrasound therapy and some evidence for the use of extracorporeal shock wave therapy in this condition.

If conservative treatment fails, invasive techniques can treat this condition.  An example is lavage with needle aspiration. In more severe cases, a shoulder arthroscopy may be necessary to debride the shoulder joint.

As physiotherapists, we are trained to diagnose shoulder conditions and will refer for radiological imaging. It’s best to get to a physiotherapist as early as you can! Leaving the injury for longer may cause it to progress to the chronic form of the condition which requires more invasive forms of treatment. With early intervention and the right treatment plan, you will be back at the gym doing your usual exercise program in no time!