Opening Hours
Monday - Saturday 8AM - 8PM

Calcific Tendinopathy

Home / Conditions / Calcific Tendinopathy

Introduction

Calcific tendinopathy refers to the deposit of calcium in a tendon, most often in those of the rotator cuff muscles of the shoulder. The most commonly affected tendon is the Supraspinatus which is observed in 80% of cases (Serafini et al., 2009).

 

 

Signs & Symptoms

 

Typically, calcific tendinopathy will come on gradually with relatively low severity shoulder pain which typically worsens overnight and can limit shoulder movement.

 

There are 3 stages of clinical presentation:

  • Chronic (silent) Phase – usually asymptomatic, present for several years.
  • Acute Painful Phase – explicitly painful (particularly at night) with reduced function.
  • Mechanical Phase – may present with tendon ‘impingement’ and pain is commonly less severe.

 

Typical Symptoms:

  • Pain at night which impacts sleep.
  • Constant dull ache.
  • Exacerbated when moving the shoulder.
  • Reduced movement and/or stiffness.
  • Palpation tenderness localised to the affected tendon.

(Fusaro et al., 2011; Gimblett et al., 1999)

Causes

The exact cause of calcific tendinopathy is unclear; however, several have been suggested including reduced blood flow, excessive compression, those with a metabolic disorder and with local degeneration. Calcific tendinopathy can be present in 2.5-7.5% of asymptomatic shoulders, it is seen significantly more commonly in females (70% of cases) and those in their 40’s.

Assessment & Diagnosis

Your Physio will ask for a history of your symptoms proceeded by carrying out a clinical examination so that a precise and timely diagnosis can be given to ensure the most effective treatment cab be put in place immediately. Your Physiotherapist will work closely with you to set individualised treatment goals for you to aim at and will regularly re-assess you to measure your progress and make any necessary modifications in your treatment.

Self-Management

Your Physio will explain the condition and educate you on self-management strategies in the early stages before the condition has progressed to a chronic issue. This may include recommending medicine to control pain, activity modification techniques which will keep you functional in ways that avoid irritation and avoidance of aggravating activities. As you recover, you will be given ongoing support and advice so that you can manage by yourself and prevent re-occurrence.

Physiotherapy

Physiotherapy input will allow a progressive rehabilitation to be implemented to strategically load the affected tendon and will help restore full shoulder movement and function. Manual therapy techniques including joint and soft tissue mobilisations may be used to support recovery. All of these modalities will help increase blood flow to the associated structures to allow natural re-absorption processes to take place.

Escalation of Treatment

Medical management usually is that of non-steroidal anti-inflammatory drugs or a steroid injection but there is little evidence that they promote reabsorption of calcium deposits.

 

Ultrasound-guided needle aspiration under local anaesthetic has been previously employed to remove some of the calcium deposits with favourable outcomes up to 2 years. This is most effective when performed early in the condition’s development when the deposits can be removed easier.

 

Surgical removal through arthroscopy is an option for patients in chronic cases when the calcium deposits are harder. It is also thought that the surgical procedure stimulates the body’s calcium reabsorption system which is desirable (Lam et al., 2006).

References

Fusaro, I., Orsini, S., Diani, S., Saffioti, G., Zaccarelli, L., & Galletti, S. (2011). Functional results in calcific tendinitis of the shoulder treated with rehabilitation after ultrasonic-guided approach. Musculoskeletal surgery95(1), 31-36.

 

Gimblett, P. A., Saville, J., & Ebrall, P. (1999). A conservative management protocol for calcific tendinitis of the shoulder. Journal of manipulative and physiological therapeutics22(9), 622-627.

 

Lam, F., Bhatia, D., Van Rooyen, K., & de Beer, J. F. (2006). Modern management of calcifying tendinitis of the shoulder. Current Orthopaedics20(6), 446-452.

 

Serafini, G., Sconfienza, L. M., Lacelli, F., Silvestri, E., Aliprandi, A., & Sardanelli, F. (2009). Rotator cuff calcific tendonitis: short-term and 10-year outcomes after two-needle US-guided percutaneous treatment—nonrandomized controlled trial. Radiology252(1), 157-164.

Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
blog
patient-resources
what-we-do
clinics

Appointment Enquiry

Please note - this is only an enquiry form, we will contact you to confirm appointment details.

"This is a great company to work with. They helped me get back on my feet in no time."
Toby Callinan
"My back is 100% better now. I can't believe how much improvement a few sessions can make. Thanks so much!!"
Laura White
"I have never had acupuncture before and I can't believe the difference it has made for my chronic back pain. I am now able to control the symptoms and have got back my normal life."
Mrs Hacker
"I was referred to you via the GP on the NHS & you were able to contact me very soon, which was appreciated.
Your service was very professional, you called at the appointed time, you listened & responded. You emailed the specific exercises I need the same day. "
Sian from London

Latest From Twitter

Like Our Page on Facebook

© 2020 Pure Physiotherapy. All Rights Reserved.

Terms and Conditions Privacy Policy Patient Resources Professionals