Tendon calcification in the shoulder

Everything you need to know about tendon calcification in the shoulder: symptoms, cause, surgery and treatment

Tendon calcification occurs mainly in the tendons around the shoulder head. It is estimated that three to five percent of people suffer from this disorder, whose official medical term is “calcifying rotator cuff tendinitis.” ‘Calcifying’ refers to calcium spots and ‘rotator cuff’ to the four muscles that together form the shoulder belt. These muscles are attached to the shoulder bones and joints with tendons. That is where the problem occurs.

What is tendon calcification in the shoulder?

Tendon calcification
In this condition, calcium fragments appear in one of the tendons around the shoulder. This is as soft as or slightly harder than toothpaste. Due to the accumulation of calcium in the tendon, it can swell. This causes the tendon to get stuck below the shoulder cap when lifting the arm. At some point, the calcium particles can escape from the tendon. The body reacts with a severe inflammatory reaction that can cause a severe pain.

Also read the article on the tendon inflammation in the shoulder.

What is the cause of tendon calcification in the shoulder?

It is not known what causes this condition. There is no relation between calciferous rotator cuff tendinitis and osteoarthritis or osteoporosis. Also, there has been no connection between this condition and excessive calcium intake via food, an accident or overload. Doctors suspect that the tendon calcification in the shoulder is due to reduced blood flow, which causes certain cells to turn into wrong forms of calcium. A hereditary predisposition might often play a role. This condition is most common in women (and thus less in men) between the ages of 40 and 50. In 50 percent of the patients there is a calcium deposit in the tendons of both shoulders. Usually only one shoulder causes pain.

What are the symptoms of tendon calcification in the shoulder?

Not everyone with a tendon calcification has symptoms, which do not arise until the calcium deposits become too large. At that point, the thickened tendon can get closed in and pain occurs while lifting the arm or lying on the shoulder. Also, the shoulder can be moved less well. When the calcium particles are released from the tendons, they enter the mucus membrane, which is between the tendons and the shoulder roof. Then a severe inflammatory reaction occurs. Read more about a mucous membrane inflammation.
This is accompanied by severe pain. Also, the shoulder can barely be used. This phase is often seen as the beginning of recovery of the calcium affected tendons.

How is tendon calcification diagnosed?

The doctor will first conduct a physical examination in order to determine whether there is a painful position when lifting your arm. In addition, an X-ray will be made on which the calcium spots are well visible.

How is a tendon calcification in the shoulder treated?

In most cases, the doctor will not do anything. The shoulder problems will disappear naturally, when the calcium in the tendons dissolves spontaneously. However, this may take several months to even several years. Sometimes your doctor will advise you to take Paracetamol against the pain. corticosteroïdWith continuous and severe pain, the doctor can inject the shoulder with an anti-inflammatory drug (corticosteroid). Usually one injection is sufficient to be pain free for a long time. If necessary, the injection can be repeated. Another treatment option is barbotage or needling. With an echo, the correct location of the calcium deposit is determined. The tendon is then pierced with a needle, which will dissolve the calcium.

When is surgery performed with tendon calcification in the shoulder?

The doctor will only propose surgery if the other treatments are not effective or when there is severe pain or movement limitation. Through a viewing operation, the calcium deposit will then be removed. This procedure is performed under general anesthesia. The tendons of the shoulders are then checked for the presence of calcium deposits. Then an incision is made and the calcium pushed out. Subsequently, the mucus bursary is rinsed to remove the released calcium crystals. Occasionally, too little calcium is released from the tendon. In that case, the surgeon wants to free up additional space for the swollen tendon. A part of the bone on the edge of the shoulder roof is then removed.

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