Calcific Tendonitis

What is Calcific Tendonitis?

Calcific tendonitis is a condition in which calcium deposits develop in the muscles or tendons of the body.  These deposits can cause inflammation in the muscle or tendon tissue.  This results in pain in the area.  When the deposit occurs near in tissues near a joint, such as the shoulder, it can also cause mechanical irritation with motion of the joint.  Calcific tendonitis can occur in any muscle or tendon. It most commonly affects the rotator cuff of the shoulder.

The buildup of calcium deposits in the rotator cuff tendon causes pressure in the tendon tissue and chemical irritation in the tendon.  It also causes mechanical irritation with motion of the shoulder joint.  The pain can be a chronic, aching, and annoying.  In some instances, the pain can be very intense.  Patients sometimes describe the pain as one of the worst pains in the shoulder.

The calcium deposit can thicken the rotator cuff tendon.  This enlarged tendon can impinge in the subacromial space as the arm is elevated and/or abducted.  The subacromial space is the space between the rotator cuff and overlying acromion bone.  Individuals often report popping, catching, grinding, or crunching with shoulder motion.  The complain of pain with motion.

It is unclear why these calcium deposits develop in the rotator cuff.  Calcific tendonitis tends to affect people between the age of 30 and 60.  There is no distinct association with medical diseases.

How is Calcific Tendonitis Diagnosed?

Diagnosis of calcific tendonitis is often verified by clinical evaluation and x-ray radiographs.  Occasionally MRIs and ultrasound can be used to evaluate the rotator cuff for associated tears. 


Symptoms of calcific tendonitis include pain (often severe), stiffness, popping with motion, and a sense of weakness due to pain.

Several proposed treatments for calcific tendonitis have been developed to help individuals recover motion and eliminate pain.  Most treatments are non-surgical in nature.  Advocated treatments include physical therapy for stiffness and pain relief, cortisone injections with percutaneous needling of the calcium deposit, and PRP (platelet rich plasma) injections.  The most common and potentially most efficacious of these treatments is often a combination of a cortisone injection with percutaneous needling followed by a short course of physical therapy to regain motion.   

About 10% of patients with calcific tendonitis may require arthroscopic surgical debridement, excision of the calcium deposit, and possible rotator cuff repair after resection.  The indication for performing a rotator cuff repair is dependent upon the extent of calcium excision performed and resultant defect that remains in the rotator cuff.  Often, an acromioplasty procedure (shaving of the undersurface of the acromion) and bursectomy (cleaning out of the inflamed lubricating structure of the rotator cuff) are performed to decompress the subacromial space to give the rotator cuff more space to glide through with shoulder motion.

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