Calcification of a shoulder tendon — known as calcific tendinitis — is a very common pathology. It typically affects patients between the ages of 30 and 60. Shoulder pain is generalised, sometimes radiating to the neck or arm.
It is most often a calcification of the supraspinatus, although it may be found on any of the rotator cuff tendons. Strictly speaking, it is not a calcification of the shoulder bone, but a deposit of crystals within one of the cuff tendons. The exact origin of these shoulder calcifications is not known. They are not linked to the food we eat. Shoulder tendon calcifications always eventually clear up on their own. When they evacuate spontaneously, the pain is extremely sharp.
Treatments to consider before surgery
Since shoulder calcification, as noted above, will eventually evacuate spontaneously, the initial approach is to wait.
A corticosteroid injection may be performed before considering treatment of the shoulder calcification. Shockwave therapy is not particularly effective. Overall, physiotherapy has little role to play in cases of shoulder calcification.
Surgery for shoulder calcification
The procedure is performed by a shoulder specialist. The surgeon begins with shoulder arthroscopy, sometimes combined with an acromioplasty, then evacuates the calcification (see video).
Depending on the size of the shoulder calcification, ultrasound-guided evacuation by a radiologist may be proposed.
Course of the procedure
The anaesthetist will begin by numbing the nerves close to the shoulder. Surgery for shoulder calcification is performed under local anaesthesia, as a day case, and you will stay only a few hours at the clinic.
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● Minimal use of the arm (= simple daily activities: washing / dressing / meals)
● Arm in a sling for 2 days only
● Self-rehabilitation exercises 1, 2 & 4 to be done 5 times/day
● Maximum 30 minutes of walking per day (no long walks)
N.B.: in 20% of cases the shoulder is stiff and painful at the third week
(early frozen shoulder — an injection is prescribed)
● Lifting of light objects
● Nothing heavy, nothing repetitive, no housework
● Resuming driving
● Self-rehabilitation, all exercises
● Maximum 45 minutes of walking (no long walks)
● Authorisation to gradually resume housework, road / indoor cycling, swimming and walking.
● All self-rehabilitation exercises
Physical activity, lifting, DIY, gardening.
The natural treatment for shoulder calcification is time. As we have seen, shoulder calcification will eventually evacuate spontaneously. Patience is therefore essential. We generally wait at least a year and after several shoulder injections before proposing surgery.
Osteopathy plays little role in shoulder calcification itself. However, it can be useful in treating any shoulder pain linked to muscular contractures.
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