Calcific Tendonitis Of The Shoulder

What is Calcific Tendonitis?

If you’re dealing with persistent shoulder pain that doesn’t seem to go away or gets worse when you try to lift your arm, you might be experiencing calcific tendonitis.

This condition happens when small calcium deposits build up inside the tendons, most often in the shoulder’s rotator cuff. These deposits can trigger inflammation and intense pain, sometimes making sleeping hard, reaching overhead, or even getting dressed in the morning.

At Resilience Orthopedics, Dr. Pamela Mehta specializes in diagnosing and treating shoulder conditions like calcific tendonitis.

Whether your pain started suddenly or has been building over time, she’ll work with you one-on-one to create a treatment plan that fits your lifestyle and helps you move comfortably again, without unnecessary delays or cookie-cutter care.

Causes

Doctors aren’t exactly sure why calcific tendonitis occurs, but we do know it’s more common in people between the ages of 30 and 50 and tends to show up without an apparent injury.

Several factors may increase your risk:

Tendon wear and tear: Our tendons naturally lose some of their strength and flexibility as we age. This degeneration may lead to calcium building up where the tendon is weakest.

Repetitive shoulder use: Jobs or sports that involve lots of overhead movement, like swimming, tennis, painting, or lifting, can place extra stress on the rotator cuff, increasing inflammation and the chance of calcium deposits.

Poor blood supply: Some areas of the shoulder tendons don’t get as much blood flow, which can slow healing and may lead to calcium buildup over time.

Genetics: Some people are more likely to develop calcific tendonitis due to inherited traits.

Metabolic conditions: Health issues like diabetes and thyroid disorders have been linked to a higher risk of this condition. Dr. Mehta may factor this into your treatment plan if you have either.

Symptoms

Calcific tendonitis in the shoulder can cause intense, nagging pain that makes everyday tasks difficult. Many patients describe pain that radiates down the arm or wakes them up at night.

Here’s what you might experience:

• Sharp shoulder pain, especially when lifting your arm
• Limited motion or stiffness, making it hard to reach overhead or behind your back
• Tenderness when pressing on the shoulder
• Swelling or warmth over the joint
• Shoulder weakness, especially when lifting or pushing

This pain can come on suddenly or gradually. If these symptoms affect your sleep or your ability to move comfortably, Dr. Mehta can help diagnose the root cause and build a treatment plan around your needs.

Diagnosis

Investigations

Doctors use several imaging tools to diagnose calcific tendonitis and rule out other conditions. Such as:

X-ray

This quick, in-office test can clearly show calcium deposits in the tendon. It’s often the first step in diagnosing calcific tendonitis.

MRI

For more complex cases, an MRI gives detailed images of the shoulder’s soft tissues. This can help identify rotator cuff tears or deeper inflammation that may be contributing to your pain.

Whichever method is used, the goal is simple: fast, accurate answers and a clear path forward.

Ultrasound

Ultrasound offers a close-up look at the tendon’s structure and any deposits. It also helps guide procedures like barbotage.

Stages of developing calcific tendinitis

Calcific tendonitis doesn’t happen overnight – it develops in stages, and each stage feels slightly different. Here’s how it typically progresses:

1. Pre-calcific Stage

At this point, you won’t feel any symptoms. However, inside the tendon, the cells begin to change, making the area more likely to collect calcium deposits later.

2. Calcific Stage

This stage has three phases:

Resorptive Phase: This is when your body tries to break down and absorb the calcium. It’s also the most painful phase—many people describe sharp, intense shoulder pain that can keep them up at night.

Formative Phase: Small calcium crystals begin to form. You may feel mild discomfort or no pain at all.

Resting Phase: The calcium sits quietly in the tendon. You might feel occasional pain with specific movements.

3. Post-Calcific Stage

After the calcium is absorbed, your tendon begins to heal. Pain and inflammation gradually fade, and shoulder movement improves.

Dr. Mehta uses imaging and your symptoms to figure out your stage so that treatment can be as targeted and effective as possible.

Grading of Calcific Tendinitis

Calcific tendinosis usually depends on the size and location of the calcium deposits. It is also based on the severity of symptoms. The grading helps in determining the appropriate treatment approach.

Gartner and Heyer Classification of Calcific Tendinitis

Type I: Well-defined, dense calcification: formative stage.

Type II: Soft edges with either dense or sharp, transparent calcification.

Type III: Cloudy and translucent appearance without clear boundaries; resorptive stage.

Severe calcific tendonitis in the shoulder

Large or multiple calcium deposits in the shoulder cause severe calcific tendonitis, which causes significant pain and dysfunction and disrupts daily routines. If conservative measures fail, aggressive treatments, including surgery, may be necessary.

Treatment

Various ways to treat calcific tendinitis exist. It depends on the symptoms and how well initial treatments worked. The goal is to ease pain, reduce inflammation, and restore shoulder function. Recovery times vary by treatment. Non-surgical methods take a few weeks. Surgical ones take several months.

Non-Surgical

Barbotage & Lavage

Barbotage, also known as needling, involves a gentle insertion procedure. A needle breaks up and aspirates calcium deposits using ultrasound guidance. Then, a small amount of sterile fluid is used to flush out the calcium- this part is called lavage.

The procedure is done right in the office under local anesthesia. Most patients can go home the same day and feel improvement within a few weeks. It’s a great option for people who want fast relief and prefer to avoid surgery.

Shock-Wave Treatment

Shockwave treatment involves using high-energy sound waves to break down the calcium deposits. There are two types:

• Extracorporeal Shock Wave Therapy (ESWT): Uses focused shock waves. It breaks down calcifications in the affected area. This method is non-invasive and usually requires several sessions.

• Radial Shock Wave Therapy (RSWT): Uses a different, less focused shock wave. It expands in a radial pattern, differing from ESWT’s method. It is generally used for broader areas of pain and requires many treatments.

ESWT and RSWT have distinct shock wave characteristics. ESWTs are more precise and target specific calcifications.

Therapeutic Ultrasound

Therapeutic ultrasound is a non-invasive treatment that uses sound waves to help reduce pain and promote healing. It works by gently warming the tissue and improving circulation around the calcium deposits.

This treatment used to be more common but is now less frequently used, as other methods like barbotage or shockwave therapy tend to work better for most people. At Resilience Orthopedics, Dr. Mehta will help you decide if ultrasound might still be helpful for your specific case – especially if you’re looking for gentle, non-surgical options.

Surgery for Calcific Tendonitis of the Shoulder

If non-surgical treatments don’t relieve enough, Dr. Mehta may recommend a minimally invasive shoulder surgery. This is often considered when calcium deposits are large, causing ongoing pain or limiting movement.

Arthroscopic removal

This is the most common surgical procedure for calcific tendonitis. Dr. Mehta uses small incisions and a camera to locate and remove the calcium deposits. If needed, she may also perform subacromial decompression to relieve pressure in the joint.

Benefits:

• Excellent success rates when performed at the right stage
• Faster recovery than open surgery
• Less pain and scarring

Open Surgery

Rarely needed, open surgery may be recommended if the calcium deposits are very large or if the rotator cuff is severely damaged. Dr. Mehta may also perform a tendon repair during this procedure if needed.

Downsides:

• Longer recovery
• Slightly higher risk of complications
• Usually reserved for advanced or complex cases

No matter the surgical route, you’ll receive personal follow-up and rehabilitation guidance from Dr. Mehta herself, not handed off to assistants or staff.

Recovery from Calcific Tendinosis

Recovery depends on your treatment plan, but here’s what to expect:

After Non-Surgical Treatment

Most patients feel relief within a few weeks. Treatments like barbotage or shockwave therapy often reduce pain significantly within 1–2 months. You may need physical therapy to restore full strength and mobility.

After Surgery

• Arthroscopic recovery: Most patients return to normal activities within 2–3 months.
• Open surgery recovery: Healing may take 4–6 months, especially if tendon repair is involved.

Throughout recovery, Dr. Mehta will personally guide your care, making adjustments based on your goals and how you’re feeling.

Conclusion

If you’re struggling with shoulder pain that disrupts your sleep or daily routine, you don’t have to live with it.

Calcific tendonitis can be frustrating, but with the proper care, it’s highly treatable. Whether in the early stages or experiencing severe pain, Dr. Pamela Mehta can help guide you through a personalized treatment plan.

You’ll receive expert care tailored to your needs, from advanced imaging to non-surgical treatments like barbotage or shockwave therapy.

Book a consultation today and take the first step toward restoring comfort and strength in your shoulder with the compassionate, one-on-one attention you deserve.