Calcific Tendonitis

Calcific tendonitis is a condition where calcium deposits build up in a tendon, most commonly in the shoulder. Tendons are strong, flexible tissues that connect muscles to bones and help your body move. When calcium collects in a tendon, it can cause irritation, inflammation, and pain. This condition most often affects the rotator cuff tendons, which help lift and rotate the arm.

Calcific tendonitis can develop slowly and may go unnoticed at first, or it can suddenly become very painful when the deposits begin to break down. Although it can be uncomfortable, it is a treatable condition and often improves with proper care.

What are the symptoms?

The symptoms of calcific tendonitis can vary depending on the stage of the condition. In the early stages, many people have little to no pain, even though calcium deposits are forming. As the condition progresses, symptoms often become more noticeable. The most common symptom is shoulder pain, which may be mild at first and gradually worsen. The pain is often felt on the outside of the shoulder or upper arm and may increase when lifting the arm or reaching overhead.

Some people experience sudden, intense pain if the calcium deposit starts to dissolve. This phase can be especially uncomfortable and may make it difficult to move the shoulder at all. Pain may also interfere with sleep, particularly when lying on the affected side. Other symptoms can include stiffness, reduced range of motion, and a catching or pinching sensation when moving the arm. In more severe cases, everyday activities like dressing, driving, or reaching for objects can become difficult.

What causes calcific tendonitis?

The exact cause of calcific tendonitis is not fully understood, but several factors are believed to contribute to its development. One common theory is that it results from changes in the tendon over time. As tendons age or experience wear and tear, they may become more prone to calcium buildup. Reduced blood flow to the tendon may also play a role, making it harder for the body to maintain healthy tissue.

Another possible cause involves the body’s natural healing response. Some experts believe that calcium deposits form as part of a process where the body tries to repair damaged tendon tissue. Over time, these deposits can grow larger and lead to inflammation and pain. Hormonal factors and metabolic conditions may also influence the likelihood of developing calcific tendonitis, although more research is needed to fully understand these connections.

It is important to note that calcific tendonitis is not caused by consuming too much calcium in your diet. The deposits form locally in the tendon and are not directly related to calcium levels in the bloodstream.

Certain factors may increase the risk of developing calcific tendonitis. Age is one of the most significant risk factors, with the condition most commonly affecting adults between the ages of 30 and 60. It typically affects women.  Repetitive shoulder movements, especially those involving overhead activities, may increase the likelihood of tendon irritation and calcium buildup.

People with jobs or hobbies that require frequent shoulder use, such as painting, lifting, or sports like tennis and swimming, may be at higher risk. Additionally, individuals with a history of shoulder injuries or chronic shoulder problems may be more susceptible.

Diabetes and thyroid disorders are strongly linked with calcific tendonitis. Poor posture and muscle imbalances in the shoulder can also contribute by placing extra stress on the tendons over time.

How is it diagnosed?

Diagnosing calcific tendonitis usually begins with a detailed medical history and physical examination. Your orthopedic provider will ask about your symptoms, when they started, and what activities make them better or worse. During the physical exam, they will assess your shoulder’s range of motion, strength, and areas of tenderness.

Imaging tests are usually needed to confirm the diagnosis. X-rays are the most common and effective way to detect calcium deposits in the tendon. These images can clearly show the size and location of the deposits. In some cases, an ultrasound may be used to provide a closer look at the tendon and surrounding tissues. Ultrasound can also help guide certain treatments if needed.

An MRI may be recommended if there is concern about other shoulder problems, such as a rotator cuff tear. While MRI is not always necessary for diagnosing calcific tendonitis, it can provide detailed information about soft tissues and help rule out other conditions.

Early diagnosis can make a difference in managing symptoms and preventing the condition from worsening. If you or a loved one are experiencing persistent shoulder pain or limited movement, seeking evaluation from one of our board – certified and fellowship – trained orthopedic surgeons is an important first step toward relief and recovery.