Calcific tendonitis: what it is, symptoms and treatment

Calcific tendonitis, also known as calcific tendonitis, occurs when there is a deposition of small calcium crystals in a tendon, which can cause pain and difficulty moving the affected limb. In most cases, the body can naturally reabsorb the accumulated calcium, however, when this does not happen, physiotherapy treatment can be carried out and, in more serious cases, surgery.

This type of tendinitis is more common after the age of 40, and in some cases can affect both sides of the body, in most cases affecting the shoulder, mainly the supraspinatus tendons and the rotator cuff. It is important that calcific tendonitis is investigated by a physiotherapist or orthopedist so that the need to initiate the most appropriate treatment can be assessed.

Calcific tendonitis symptoms

The symptoms of calcific tendonitis are related to the amount of calcium deposited in the tendon, resulting in inflammation and symptoms such as pain, decreased range of motion and difficulty moving the affected limb.

It is not yet known exactly why this calcification forms, but the most accepted theory is that it forms due to a decrease in blood reaching the inflamed tendon, resulting in a deposition of calcium salts there. Changes in the thyroid and estrogen metabolism can also favor its formation.

How the diagnosis is made

The diagnosis of calcific tendonitis is made by an orthopedist or physiotherapist through imaging tests, mainly X-rays, in which the presence of a small whitish area at the site of the calcification can be observed.

When palpating the tendon, the person should feel some pain, but it is not possible to say that there is calcification solely due to pain and therefore an imaging test can be useful, although it is not normally requested just because of this suspicion.

How the treatment is carried out

In most cases of calcific tendonitis, the body is able to naturally reabsorb the calcium accumulated in the tendons, without the need for specific treatment. However, when symptoms are frequent and limiting, it is important that a doctor is consulted so that a more complete assessment of the tendinitis can be carried out and, thus, more specific treatment can be initiated.

The treatment normally indicated involves carrying out some physiotherapy sessions, often using electrotherapy, to reduce inflammation and pain in the surrounding tissues, as well as ultrasound therapy, which is also capable of reducing calcification, with excellent results. Painkillers and anti-inflammatories in tablets or ointments can also help combat pain.

In more serious cases, when no treatment brings relief of symptoms, arthroscopy surgery may be indicated. This surgery consists of scraping the calcified area, completely eliminating the calcification. Infiltrations with anesthetics and corticosteroids are also indicated to immediately relieve pain, but can only be performed 1 to 2 times a year.

See some quick tricks to combat pain in the following video:

Physiotherapy for calcific tendonitis

In physiotherapy, TENS and ultrasound are indicated for pain control, although it is not yet known exactly how ultrasound acts to reabsorb deposited calcium. It increases the temperature of the area and blood flow, facilitating the removal of calcium deposits.

Exercises such as stretching and muscle strengthening with elastic bands such as Theraband are recommended, as are joint manipulation techniques. Pendulum exercises are excellent strategies for reducing pain and maintaining the integrity of the capsule, preventing the shoulder from being in a protective position, which generates more pain and restricted movement.

Resting the affected limb is indicated when there is pain and limited movement and therefore, whenever possible, holding heavy objects with the affected arm should be avoided. However, absolute rest is not necessary and therefore the use of a sling is not recommended because it is important to maintain some movement to maintain the production of synovial fluid that irrigates the joint.