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What is Calcific Tendinitis?
Written by Medicover Team and Medically Reviewed by Dr Rahul Ramchandra Supe , Orthopedics
Calcific tendinitis is a condition characterised by the accumulation of calcium deposits in a tendon, leading to pain, inflammation, and restricted movement. It most commonly affects the shoulder tendons, especially the rotator cuff, but it can also occur in the hip, elbow, or knee.
The calcium buildup irritates surrounding tissues, leading to swelling and discomfort, particularly during arm or joint movement. The exact cause isn't always known, but it may be linked to aging, repetitive motion, or reduced blood supply to the tendon.
Although painful, calcific tendinitis is often treatable with rest, physiotherapy, medications, or, in some cases, minor procedures to remove the deposits.
Calcific Tendinitis vs. Rotator Cuff Injury
Calcific tendinitis is characterised by the formation of calcium deposits in the shoulder tendons, resulting in sudden pain and inflammation. It often affects the supraspinatus tendon and can cause pain even at rest.
A rotator cuff injury involves a tear or strain in the shoulder tendons, typically resulting from overuse, ageing, or injury. It causes pain, weakness, and limited movement.
Key difference:
Calcific tendinitis is due to calcium buildup, while rotator cuff injuries involve tendon damage.
Who Does Calcific Tendinitis Affect?
Calcific tendinitis most commonly affects:
- Adults between the ages of 30 and 60
- Women are more than men
- People who do repetitive shoulder movements (like athletes, painters, or manual workers)
- Those with metabolic conditions like diabetes or thyroid disorders
- Individuals with poor posture or limited shoulder mobility
It often develops without a clear cause but is more likely in people who repeatedly put stress on their shoulder tendons.
How Common is Calcific Tendinitis?
Calcific tendinitis is a relatively common condition, especially in adults aged 30 to 60 years. It affects about 2% to 7% of healthy adults, and up to 20% of people with shoulder pain may have calcium deposits in their tendons.
It is more common in women than men and often goes undetected unless it causes significant pain or limited shoulder movement.
While most cases occur in the shoulder, it can also affect the hip, elbow, or knee, though less frequently.
What are the Symptoms of Calcific Tendinitis?
Calcific tendinitis often affects the shoulder and may develop gradually or suddenly. Common symptoms include:
- Sharp or aching shoulder pain, especially when lifting the arm
- Pain at night, which may disrupt sleep
- Stiffness or limited range of motion in the shoulder
- Tenderness around the joint
- Sudden severe pain if calcium deposits start to break down
- Swelling or warmth around the affected area in some cases
The pain can range from mild to intense and may worsen with activity or pressure on the joint.
Stages of Calcific Tendinitis
Calcific tendinitis develops in stages, each with different symptoms and tissue changes. Understanding these stages helps guide treatment and recovery:
Pre-Calcific Stage
In this early phase, the tendon begins to change due to wear and tear or poor blood flow. There are usually no symptoms; however, the tendon becomes more likely to accumulate calcium.
Calcific Stage
This stage is divided into three parts:
- Formative Phase: Calcium begins to accumulate in the tendon. You might not feel any pain yet.
- Resting Phase: The calcium deposit remains stable. Pain may be mild or absent.
- Resorptive Phase: The body begins to break down and absorb the calcium. This is the most painful stage, often causing intense shoulder pain and inflammation.
Post-Calcific Stage
The calcium is gone, and healing begins. New tendon tissue forms and pain gradually decreases. Physical therapy is often needed to restore strength and movement.
Each stage varies in duration and symptoms. Some people may progress through all stages without experiencing severe pain, while others may encounter significant discomfort, particularly during the resorptive phase.
What are the Causes of Calcific Tendinitis?
The exact cause of calcific tendinitis isn't fully understood. Still, it's believed to result from a combination of factors that lead to calcium deposits forming in the tendons, especially around the shoulder.
Here are the leading causes and contributing factors:
- Tendon Degeneration: Over time, tendons can weaken due to age or overuse. This may trigger changes in tendon tissue, increasing the likelihood of calcification.
- Poor Blood Supply: Reduced blood flow to certain parts of the tendon can affect healing and lead to calcium buildup.
- Repetitive Shoulder Movements: Frequent overhead activities or strain on the shoulder tendons can increase the risk of irritation and micro-tears, leading to calcium deposits.
- Hormonal and Metabolic Factors: Conditions like diabetes, thyroid disorders, or hormonal imbalances may increase the risk of calcium buildup in tendons.
- Genetic Predisposition: Some individuals may be more susceptible to developing calcific deposits due to inherited factors, although this relationship is still being investigated.
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Get Second OpinionHow is Diagnosing Calcific Tendinitis?
Diagnosing calcific tendinitis involves a physical exam and imaging tests to confirm the presence of calcium deposits in the affected tendon.
Your doctor will begin by asking about your symptoms, such as shoulder pain, stiffness, and limited movement.
They'll examine the joint for tenderness and reduced range of motion.
What Tests Will Be Done To Diagnose Calcific Tendinitis?
To confirm the diagnosis, imaging tests are used:
- X-rays are the most common and can clearly show calcium buildup in the tendons.
- Ultrasound may be used to see soft tissues and detect smaller deposits.
- MRI can help rule out other shoulder conditions, such as rotator cuff tears or bursitis.
These tests help determine the size and location of the calcium deposits, which guides treatment planning.
What are the Treatment Options for Calcific Tendinitis?
Treatment for calcific tendinitis depends on the severity of symptoms and the stage of the condition. Many people recover with non-surgical care, while others may need more targeted treatments if pain persists.
Conservative (Non-Surgical) Treatments
Most cases improve with simple, non-invasive care:
- Rest and Activity Modification: Avoid movements that trigger pain, especially overhead motions.
- Cold or Heat Therapy: Ice packs help reduce pain and swelling; heat relaxes tight muscles.
- Medications: Over-the-counter pain relievers, such as ibuprofen or naproxen, reduce inflammation and discomfort.
- Physical Therapy: Gentle stretching and strengthening exercises enhance mobility and accelerate healing.
Advanced Non-Surgical Procedures
If symptoms don't improve with basic care, doctors may recommend:
- Ultrasound-Guided Needling (Barbotage): A minimally invasive procedure where the calcium deposits are broken up and flushed out with a needle.
- Shockwave Therapy (ESWT): High-energy sound waves are applied to the area to break up deposits and stimulate healing.
Surgical Treatment
Surgery is rarely needed but may be considered if pain continues despite all other treatments:
- Arthroscopic Surgery: A small camera and tools are used to remove the calcium deposits from the tendon.
- This is typically an outpatient procedure with good results and a short recovery time.
With the proper care, most people with calcific tendinitis recover fully and return to normal activities without long-term problems.
When to See a Doctor for Calcific Tendinitis?
You should see a doctor if you experience:
- Persistent shoulder pain that doesn't improve with rest or home care
- Sudden, severe pain in the shoulder, especially at night
- Limited range of motion or difficulty lifting your arm
- Swelling or tenderness around the joint
- Pain that interferes with sleep or daily activities
Early treatment can prevent further tendon damage and help relieve pain more quickly. Don't ignore ongoing shoulder discomfort; it's best to get it checked.
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Recovery Time and Prognosis for Calcific Tendinitis
Most people with calcific tendinitis recover well, especially when the condition is treated early and adequately.
- Mild cases improve in a few weeks with rest, medication, and physical therapy.
- Moderate to severe cases, especially during the painful resorptive stage, may take 6 to 12 weeks or longer to heal.
- If surgery or procedures like barbotage are needed, recovery usually takes a few months, including rehab.
The overall prognosis is excellent. With the proper care, pain fades, calcium deposits dissolve or are removed, and full shoulder function returns in most cases.
Are There Side Effects of Calcific Tendinitis Treatment?
Some treatments for calcific tendinitis may cause minor side effects:
- Painkillers can upset the stomach if used for too long.
- Steroid injections might weaken the tendon or cause skin thinning.
- Shockwave therapy may lead to temporary bruising or soreness.
- Needling or surgery can cause short-term pain or swelling.
Most effects are mild and go away with time.
How to Reduce Your Risk of Calcific Tendinitis?
While calcific tendinitis isn't always preventable, you can lower your risk with a few simple habits:
- Avoid repetitive shoulder movements that strain tendons
- Warm up and stretch before physical activity
- Strengthen shoulder muscles through regular, guided exercise
- Maintain good posture to reduce tendon stress
- Manage conditions like diabetes or thyroid disorders, which may increase risk
- Take breaks during repetitive tasks or overhead work
Caring for your joints and staying active in a balanced way can help protect your tendons over time.
Calcific Tendinitis Exercises
Gentle exercises can help improve shoulder flexibility, strength, and pain relief during recovery from calcific tendinitis. Always consult a doctor or physiotherapist before starting.
- Pendulum Swings
- Wall Crawls
- Towel Stretch
- Shoulder Blade Squeeze
- External Rotation with Band
Tip: Stop if any exercise causes sharp pain. These movements should be gentle and controlled. For best results, do them under professional guidance.
Our Experience in Treating Calcific Tendinitis
At Medicover Hospitals, we have extensive experience managing calcific tendinitis with a patient-first approach. Our team of orthopedic specialists, radiologists, and physiotherapists work together to ensure accurate diagnosis using advanced imaging and prepare treatment based on the stage and severity of the condition.
We offer both non-surgical options, such as guided needling, physiotherapy, and pain management, as well as minimally invasive procedures when necessary. Our goal is to alleviate pain, restore mobility, and enable patients to return to their daily activities with confidence and comfort.
