A common cause of severe shoulder pain are the calcifications in this area. They are somewhat more common in women between 40 and 50 years old and usually appear on the dominant arm, although this is not always the case. We tell you what are calcifications in the shoulder and how can you treat them.
What are shoulder calcifications?
Also called calcifying tendinitis, Calcifications in the shoulder occur when calcium deposits appear on the tendons of the shoulder. Calcium causes irritation of the rotator cuff tendons, which can lead to acute pain. They normally occur in the supraspinatus, although it can also occur in the infraspinatus or subscapularis tendon.
How does calcifying tendonitis occur?
The causes of calcifications in the shoulder. Yes, some hypotheses are being considered, which have to do with alterations in metabolism, cellular degeneration, genetics, repetitive microtrauma or endocrine disorders.
It is somewhat more common in diabetics and symptoms usually appear in the shoulder of the dominant arm, although it is not uncommon for calcification to occur in both.
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Request a second medical opinionOne of the risk factors for calcifying tendonitis It is age, since, as we age, the shoulder joint weakens. It is more common in women over 40 years of age.
Symptoms of calcifications in the shoulder
The most common symptom, for which you go to the specialist, is a Acute pain in the shoulder with no apparent cause. That is, no trauma or overexertion has occurred. This pain can also cause immobility and problems sleeping.
It is also possible a asymptomatic calcifying tendonitis, which is discovered by chance when performing an x-ray for any other pathology.
Phases of calcifying tendonitis
Calcifying tendonitis is a condition that occurs in different phases:
- Training phase, which can last several years. It is where calcium deposits are formed. It is asymptomatic or the pain is moderate.
- Resorptive phase: in it the acute pain in the shoulder, since calcium is released, which inflames the tissues. It can last between one and six months.
- In the resting phase, calcium remains stable. It continues to exist, but is not released. It usually does not show symptoms, although sometimes the pain does not disappear completely.
How are calcifications in the shoulder diagnosed?
The diagnosis of shoulder calcification begins with a detailed clinical examination, in which the specialist assesses pain, mobility, and the presence of functional limitations. Suspicion often arises when the patient reports intense pain without prior trauma, especially if it appears suddenly or disrupts sleep.
The key test is a simple X-ray, as it allows for clear visualization of the calcification in the tendon. These images show the size, shape, and position of the calcification, guiding the most appropriate treatment. In certain cases, such as when it is necessary to assess the rotator cuff or rule out other associated injuries, an ultrasound or MRI may be used, as these tests provide more precise information about the soft tissue.
Thanks to these imaging tests, the specialist can identify what stage the calcification is in and decide whether conservative treatment, physiotherapy, injections, or even an interventional procedure is best.
How are calcifications in the shoulder treated?
The basic treatment is conservative: anti-inflammatories, physiotherapy to exercise mobility and application cold for calcification in the shoulder for about ten minutes, two or three times a day.
If the pain is very strong or persists, there are infiltrations for calcifications in the shoulder based on corticosteroids and local anesthesia. This, together with a physiotherapy treatment in the hands of specialists, It can help reduce pain significantly.
Others treatments for calcifying tendonitis The specialist may consider shock waves or aspiration techniques.
Why do calcifications in the shoulder hurt so much?
The characteristic pain of calcific tendinitis is intense and sudden, and this has a physiological explanation. When calcium deposits begin to be released during the resorption phase, the body reacts with significant inflammation, especially in the rotator cuff tissues. This inflammation generates an increase in internal pressure, directly irritating pain receptors and triggering severe discomfort.
Furthermore, accumulated calcium can disrupt the normal mechanics of the shoulder. Irritated and inflamed tendons lose their ability to glide smoothly, causing painful impingement when raising the arm. This explains why everyday activities like combing hair, getting dressed, or sleeping on one's side become particularly difficult. This combination of inflammation and mechanical friction intensifies the painful sensation.
The pain often worsens at night or while resting, as blood flow changes and inflamed tissues become more sensitive. Understanding this mechanism helps explain why many patients have difficulty even resting and why early treatment is crucial for alleviating the condition.
What exercises help improve calcific tendinitis?
Physical therapy is key in the treatment of shoulder calcifications, especially once the initial pain is under control. Through exercises, the aim is to restore mobility, strengthen the rotator cuff, and improve shoulder biomechanics. Initially, gentle mobilizations are recommended to prevent joint stiffness while inflammation subsides.
Gradually, the physiotherapist incorporates strengthening exercises for the supraspinatus, infraspinatus, and subscapularis muscles, always within a tolerable pain range. The scapular muscles are also worked, as their function is essential for proper shoulder movement.
In advanced stages of recovery, functional exercises tailored to the patient are added, designed to restore the strength and mobility necessary for their work, sports, or daily life. It is important that this process be monitored by specialists to avoid incorrect movements that could delay recovery.
Are shoulder calcifications operated on?
If none of the previous options are effective, it is possible to resort to the surgery for calcifying tendonitis.
The ideal in this case is a shoulder arthroscopy, a minimally invasive surgery that is performed by introducing a device called an arthroscope connected to a high-resolution screen.
When is calcifying tendonitis operated on?
In most cases it is not necessary to surgery for calcifying tendonitis. An operation is only performed if the rest of the therapeutic options have not worked.
When should shockwave therapy be used for calcific tendinitis?
Shockwave therapy is an effective treatment for certain cases of calcific tendinitis, especially if the calcium deposits are moderate in size and the pain persists despite physical therapy and anti-inflammatory medication. This procedure involves applying high-energy acoustic waves to the affected area, which helps to break down the calcification and stimulates the regeneration of tendon tissue.
It acts directly on the calcium deposit, accelerating the body's natural reabsorption process, improving local vascularization, reducing inflammation, and significantly decreasing pain. For this reason, it is considered an intermediate option before resorting to more invasive procedures such as aspiration or surgery.
When indicated correctly, shock waves can avoid surgery and promote a faster and safer recovery.
Arthroscopy for calcifying tendonitis
The Arthroscopy is the last option to treat shoulder calcifications. In them, calcium deposits are emptied, minimizing tissue damage as much as possible. The shoulder arthroscopy It is a procedure performed by specialist traumatologists in which the shoulder joint can be observed through a high-definition screen.
The arthroscope is introduced through small incisions, as well as the instruments necessary for the operation. Usually the complete process does not exceed 90 minutes.
Recovery after shoulder arthroscopy
As it is a minimally invasive surgery, recovery is usually short and without complications. Anti-inflammatories are frequently used to relieve pain, and the affected arm may be immobilized for a few days. Likewise, a specialized physiotherapist will supervise the recovery process.
How important is therapeutic exercise in recovery?
Although initial treatment focuses on relieving acute pain with analgesics or injections, controlled physiotherapy and therapeutic exercise are key to long-term recovery. During periods of intense pain, exercises aim to maintain range of motion to prevent joint stiffness without overloading the irritated tendon.
Then, as the pain subsides, progressive muscle strengthening is implemented. Exercises are performed for the rotator cuff and scapular stabilizers. The goal is to restore shoulder function and correct any biomechanical imbalances that may have contributed to the development of the tendinitis, which is key to preventing future calcifications.
Can shoulder calcifications be prevented?
The exact causes of calcifications are not known., but if a patient has suffered them, it is very possible that they will occur again.
It is always important to eat healthily for optimal functioning of the body and go to a specialized specialist at the first symptom, if possible before feeling acute pain.
The calcifying tendonitis is common and it can be very disabling. It is important not to wait and have a shoulder specialist traumatologist to receive early diagnosis and treatment.
At Clínica Elgeadi we have nationally and internationally recognized professionals who complement their experience with the best technological means.
30 thoughts on “¿Qué es la tendinitis calcificante? Operación y prevención”
There is some natural remedy for this condition.
Good morning, Mary.
Thank you very much for your comment on our blog. For calcification in the shoulder, it is best to consult with a team of expert traumatologists, so that the treatment is as accurate as possible. You can make an appointment with our traumatology experts at this link: https://clinicaelgeadi.com/contacto/
All the best.
Where are they located?
Good morning, Blanca.
Thanks for writing on our blog.
You can find our trauma clinic at Calle del Corazón de María, 78 in Madrid. Our team of specialists will be eager to help you resolve your pathology. All the best.
Hello!!, I love your way of creating content, the world needs more people like you
Thank you very much for your words!
We will continue creating content for all of you.
Hello, I'm Luis, I'm going through a bad time, the mutual insurance doctor informed me that I have calcification in my right shoulder seen through an x-ray. This pain hasn't let me sleep for several months and my family doctor says that I don't have anything and the doctor tells me that I can Acer, I'm dead, I'm 61 years old and my job is to move heavy rolls of fabric. Greetings, but good advice.
Hello Luis Fernando,
Thank you very much for your comment on the Clínica Elgeadi blog. We are sorry for the situation you are in. For your specific case, what we recommend is to consult with a specialist for a complete medical diagnosis. You can make an appointment with our expert shoulder traumatologists in the link provided.
We will be happy to help you and determine the best treatment for you. All the best.
Hello good morning!!!
I have calcifications in my left shoulder, I have gone to my traumatologist and he told me that they are calcifications from age but he has not sent me anything, he only told me that if it hurts a lot he could infiltrate me.
I want to know your opinion, could you do some exercise to solve it? Or I have to infiltrate.
I am from Melilla and I cannot go to your clinic.
Greetings Ana
Good morning Ana,
Thank you for visiting our trauma blog.
Regarding your question, the decision of what to do with the calcifications will depend on their size and where they are, as well as the age of the patient, etc. If there is no pain, nothing should be done.
Therefore, it would be necessary to carry out a complete study beforehand.
All the best.
Hello, good afternoon, I have been diagnosed with level I calcification. supraspinatus, they have put my arm in a sling and they recommend that when it is less painful I do some exercises three times a day, thanks in advance. All the best.
Good morning Ana,
Thank you for reporting your experience. Do you have any questions related to the topic? You can contact our specialized traumatologists if you wish.
All the best.
Hello, I am 41 years old and I have had tendonitis with calcifications in my right shoulder for 7 years. 4 years ago I had surgery for herniated discs in my cervical spine and the pain subsided a lot and a month ago I had a small accident at work, I had to put my arm down and now I'm in a rage with pain. They only give me anti-inflammatories and painkillers. The answer from my family doctor is that this is because he woke up. And the work mutuals wash their hands. Now they have immobilized my arm and in 15 days I will see a specialist.
I loved how you explained the steps to follow in detail. But my question now is, would an infiltration be good for me? Or an operation directly!? Thank you so much.
Good morning Vanessa,
Thanks for your comment.
Unfortunately, we cannot offer you a diagnosis without first studying the affected area. Therefore, you can request an appointment at our trauma clinic if you wish.
All the best.
Any recommendations in Barcelona?
Thank you
Hello Nieves, how are you? Sorry, we are currently only in Madrid and we couldn't tell you, but in Barcelona there are incredible professionals who can surely help you with your injury. A hug!
Good morning, I have a calcified tendinopathy of the supra and infraspinatus, with a size of 10mm and another 16mm. They sent me physio for 8 days, with dry needling and ultrasounds. My movement has improved minimally, you advise me to continue going to the physio or the traumatologist directly. I've been in pain for two months. I do not raise my arm horizontally above shoulder height. Thank you so much.
Hello Carolina, honestly both are compatible, I would go to the orthopedic surgeon to check me out and I would not leave physiotherapy until a specialist tells me. All the best.
Hello, good morning, I have a calcification in the supraspinatus of the left shoulder, they have told me that the solution is to infiltrate me with corticosteroids or do a barbotage since they have given me shock waves and it has not worked, which is more recommended? I am from Cadiz and I cannot travel to your clinic.
Hello Natalia,
The most appropriate treatment depends on the experience of the surgeon, as well as the technique he or she most masters. Other influencing factors are the size of the calcification, its location. The evolution of inflammation at the shoulder level. There are many factors involved and without a good exploration and images I do not dare to give you guidance.
A hug.
Hello, it's been a little over 2 years since I had an astro copy of my right shoulder because I had a condition in the supraspinatus, logically after trying physiatry then you go into shock and nothing worked but after the surgery I recovered my mobility in a 100% and Sometimes when I get stronger I feel some pain but I'm happy to be able to move my arm since before I couldn't even eat because of the pain and sometimes my arm got stuck when I raised it. My advice is not to be afraid of the astro copy Yoli from Argentina
I have my surgery tomorrow. Your comment was very helpful since I'm quite nervous. Greetings from Chile.
Hello, good afternoon.
Ultrasound showed a 2.8 mm calcification in the subscapularis tendon and small calcifications in the supraspinatus.
I have had three sessions of focal shock waves. I still haven't noticed much improvement and I am in a lot of pain all day long.
What is the difference between shock waves, focal waves and radial waves and which ones would be more indicated?
Thank you very much and best regards
Hello Luisa,
Focal shock waves act on specific areas and at greater depth, making them more effective for calcifications and deep lesions such as calcific tendonitis. Radial shock waves spread superficially and are used for larger, more superficial areas. For calcifications in tendons, focal shock waves are usually more indicated.
Greetings
I have read that the pain starts when the calcification begins to break down. Is this true? Or am I wrong?
Yes, it is true that pain may increase when the calcification begins to dissolve. This happens because as the calcium fragments break down, they release substances that irritate nearby tissues.
Greetings!
Hello,
J'ai une calcification à l'épaule qui ne soigne pas. J'ai des séances d'ergothérapie, mais cela ne soulage pas trop.
Je suis diabetic de type 2 avec une insuffisance rénale, de plus, je prends des anti coagulants, comme Asaflow et Xarelto.
Est-ce qu'une arthtoscopie pourrait être une solution?
Hello,
Nous ne donnons pas d'indications Médicales ni n'analysons de cas pécíficos par l'intermédiaire de ce média.
If you want one of our specialists to examine your case, you can contact us at +34 91 005 39 00.
Je vous prie d'agréer, Madame, Monsieur, l'expression de mes salutations distinguées.
Hello, good afternoon. I have been diagnosed with tendonitis with calcification. It is very painful. I have practically not slept for four days, taking anti-inflammatories, painkillers, and Nolotil. It is so serious. Will I ever be able to regain mobility in my arm? How come it appears suddenly and does not go away?
Hello Cristina,
Thank you for sharing your experience. Calcific tendonitis can be very painful, especially in its acute phases, and often causes difficulty sleeping and moving the arm. Although it can appear suddenly, it is usually related to small calcium deposits in the tendons, which at times trigger intense inflammation.
The good news is that, with proper treatment, most cases improve. It's important to have your case assessed by a specialist to adjust your medication and consider options such as physical therapy or even injections if the pain persists. If you wish, you can schedule an appointment so our specialists can evaluate your case and recommend the most effective treatment.
Greetings.