Calcific Tendinitis: Symptoms and Treatments

Calcific tendinitis is a condition characterized by the deposition of calcium crystals within the tendons of the rotator cuff. This condition can lead to significant discomfort and impaired function, often prompting individuals to seek medical advice. Here, we will delve into the causes, symptoms, diagnosis, and treatments of calcific tendinitis, providing a comprehensive overview for those affected by this condition.

---

What is Calcific Tendinitis?

Calcific tendinitis, also known as calcific tendinopathy, is a disorder where calcium phosphate crystals accumulate in the tendons, predominantly those of the rotator cuff. This can result in intense pain and limited mobility in the affected shoulder.

---

Causes of Calcific Tendinitis

Degeneration and Cellular Response

The exact etiology of calcific tendinitis remains unclear, but it is believed to be multifactorial. Degenerative changes in the tendon, coupled with a cellular response that promotes calcium deposition, are primary factors. These degenerative changes can be due to chronic overuse, aging, or genetic predispositions.

Metabolic Factors

Metabolic imbalances, such as those seen in diabetes or thyroid disorders, have also been implicated in the development of calcific tendinitis. These conditions can alter the normal metabolic processes within the tendons, leading to calcium crystal formation.

Trauma and Microtrauma

Acute trauma or repetitive microtrauma to the tendons can precipitate calcific tendinitis. This is often seen in individuals engaged in activities that place excessive strain on the shoulder, such as athletes and manual laborers.

---

Symptoms of Calcific Tendinitis

Acute Pain

The hallmark symptom of calcific tendinitis is acute, intense pain in the affected shoulder. This pain is often exacerbated by shoulder movements and can significantly limit daily activities.

Limited Range of Motion

Due to pain and inflammation, individuals with calcific tendinitis often experience a reduced range of motion in the shoulder. This can make it challenging to perform tasks that involve lifting or reaching.

Tenderness and Swelling

Tenderness over the affected tendon and swelling in the surrounding tissues are common. These symptoms are indicative of an inflammatory response to the deposited calcium crystals.

---

Diagnosing Calcific Tendinitis

Clinical Examination

A thorough clinical examination is the first step in diagnosing calcific tendinitis. This includes a detailed patient history and physical examination to assess pain, tenderness, and range of motion.

Imaging Studies

Imaging studies play a crucial role in confirming the diagnosis of calcific tendinitis. X-rays can reveal the presence of calcium deposits, while ultrasound and MRI provide detailed images of the tendon structure and the extent of inflammation.

---

Treatment Options for Calcific Tendinitis

Non-Surgical Treatments

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to manage pain and inflammation associated with calcific tendinitis. In some cases, corticosteroid injections may be used to provide more substantial relief.

Physical Therapy

Physical therapy is a cornerstone of non-surgical treatment for calcific tendinitis. Specific exercises aimed at strengthening the rotator cuff and improving shoulder mobility can help alleviate symptoms and prevent recurrence.

Extracorporeal Shock Wave Therapy (ESWT)

ESWT is a non-invasive treatment that uses high-energy shock waves to break down calcium deposits in the tendons. This therapy can promote tissue healing and reduce pain, making it a viable option for patients who do not respond to conservative treatments.

Ultrasound-Guided Needle Aspiration

In cases where calcium deposits are substantial, ultrasound-guided needle aspiration may be performed. This procedure involves the insertion of a needle into the tendon under ultrasound guidance to aspirate the calcium deposits, providing immediate pain relief.

Surgical Treatments

Arthroscopic Removal

For patients with persistent symptoms despite conservative treatments, arthroscopic removal of the calcium deposits may be necessary. This minimally invasive surgery involves the use of small instruments to remove the deposits and repair any damaged tendon tissue.

---

Calcific Tendinitis vs. Rotator Cuff Injury

While both calcific tendinitis and rotator cuff injuries affect the tendons of the shoulder, there are distinct differences between the two conditions. Calcific tendinitis is characterized by calcium deposition, whereas rotator cuff injuries typically involve tendon tears or inflammation without calcium buildup. Accurate diagnosis through clinical examination and imaging is essential for appropriate treatment.

---

Recovery Time and Prognosis

Recovery Time

Recovery time for calcific tendinitis varies depending on the severity of the condition and the chosen treatment approach. Non-surgical treatments typically result in gradual improvement over weeks to months, while surgical interventions may require a more extended recovery period, including post-operative rehabilitation.

Prognosis

The prognosis for calcific tendinitis is generally favorable, with most patients experiencing significant pain relief and improved shoulder function following appropriate treatment. However, recurrence can occur, particularly if underlying risk factors such as metabolic imbalances or repetitive shoulder strain are not addressed.

---

Calcific Tendinitis Exercises

Stretching Exercises

Stretching exercises are vital in maintaining shoulder flexibility and preventing stiffness. Gentle stretching of the shoulder muscles and tendons can improve range of motion and reduce pain.

Strengthening Exercises

Strengthening exercises targeting the rotator cuff muscles are crucial for stabilizing the shoulder joint and preventing further injury. These exercises should be performed under the guidance of a physical therapist to ensure proper technique and avoid exacerbating the condition.