Understanding Calcific Tendonitis: Causes and Treatments

Calcific tendonitis is a condition characterized by the accumulation of calcium deposits in the tendons of the body. This condition most commonly affects the shoulder, specifically the rotator cuff, but can also occur in other areas such as the hips and knees. Despite its common occurrence, calcific tendonitis is often misunderstood or confused with other conditions, such as tendinitis. In this article, we will explore the causes, symptoms, diagnosis, and treatment options for calcific tendonitis.

What is Calcific Tendonitis?

Calcific tendonitis is a painful condition that results from the deposition of calcium hydroxyapatite crystals in the tendons. These deposits can cause inflammation and irritation, leading to significant discomfort and impaired movement. The condition predominantly affects individuals aged between 30 and 60 years and is more common in women than in men.

Calcific Tendonitis vs. Tendinitis

It's essential to differentiate calcific tendonitis from tendinitis, as the two involve different pathological processes. Tendinitis refers to the inflammation of a tendon due to overuse or acute injury, without the presence of calcium deposits. Calcific tendonitis, on the other hand, specifically involves calcification within the tendon structure, which can lead to more persistent and severe symptoms.

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Symptoms of Calcific Tendonitis

Symptoms of calcific tendonitis can vary depending on the size and location of the calcium deposits. Common symptoms include:

Intense shoulder pain, especially at night.
Stiffness and restricted range of motion.
Tenderness in the affected area.
A sensation of catching or grinding during movement.

In some cases, individuals may experience a sudden increase in pain, known as a "painful arc," when lifting the arm.

Causes of Calcific Tendonitis

The exact cause of calcific tendonitis remains unclear, although several theories have been proposed. Some researchers suggest that it may be due to ageing or degenerative changes in the tendon, while others believe it could be a response to injury or stress. Hormonal factors and genetic predispositions have also been implicated. Understanding these potential causes is crucial for developing effective treatment strategies.

Risk Factors

Certain factors may increase the likelihood of developing calcific tendonitis, including:

Age: Most common in individuals aged 30-60.
Gender: More prevalent in women.
Diabetes: Individuals with diabetes are at a higher risk.
Shoulder Injuries: Previous injuries may predispose individuals to calcific tendonitis.
Occupation: Jobs requiring repetitive shoulder movements can increase risk.

Diagnosis of Calcific Tendonitis

Accurate diagnosis of calcific tendonitis is essential for determining the appropriate treatment plan. Diagnosis typically involves a combination of physical examination, patient history, and imaging studies.

Imaging Techniques

X-rays: Often the first step in confirming a diagnosis, as calcium deposits are easily visible.
Ultrasound: Helps assess the size and extent of the calcium deposits.
MRI: Provides detailed images of the soft tissues surrounding the tendon.

These imaging techniques are crucial in distinguishing calcific tendonitis from other shoulder pathologies.

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Treatment Options for Calcific Tendonitis

The treatment of calcific tendonitis aims to reduce pain, improve function, and eliminate calcium deposits. Treatment strategies may vary based on the severity of the symptoms and the patient's overall health.

Non-Surgical Treatments

Rest and Activity Modification: Reducing activities that exacerbate symptoms can help in managing pain.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can alleviate pain and inflammation.
Physical Therapy: Tailored exercises can improve range of motion and strengthen the surrounding muscles.
Extracorporeal Shock Wave Therapy (ESWT): Uses shock waves to break down calcium deposits and promote healing.

How to Sleep with Calcific Tendonitis

Sleeping can be challenging for those with calcific tendonitis due to the pain. Here are some tips:

Use a pillow to support the affected arm.
Sleep on your back to avoid pressure on the shoulder.
Consider a shoulder brace for added support.

Surgical Interventions

In cases where conservative treatments fail, surgical intervention may be necessary. Options include:

Needle Aspiration and Lavage: A procedure to extract calcium deposits using a needle.
Arthroscopic Surgery: Minimally invasive surgery to remove calcium deposits and repair the tendon.
Open Surgery: Reserved for severe cases or when other methods are ineffective.

Calcific Tendonitis Physical Therapy

Physical therapy plays a vital role in the recovery process for calcific tendonitis. A physical therapist can design a personalized exercise program to enhance shoulder mobility and strength. Modalities such as ultrasound therapy and heat application may also be incorporated to reduce pain and facilitate healing.

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Frequently Asked Questions

1. What are the symptoms of calcific tendonitis?

Symptoms may include shoulder pain, limited range of motion, and tenderness, indicating inflammation of the rotator cuff tendons requiring evaluation.