At a glance
Main symptoms
- Formative phase: Usually painless, calcification forms slowly
- Resting phase: Mild complaints or quiet period
- Resorption phase: Very severe pain when body starts absorbing calcification; wakes from sleep, prevents arm movement
- Hospital stay
- Most cases allow same-day discharge or 1 overnight.
- Recovery time
- 4–12 weeks
- Return to work
- Desk work in 1-2 weeks, light physical work in 3-4 weeks, heavy work in 6-12 weeks.
Calcific tendinitis is calcium crystal deposition in the rotator cuff tendons, most commonly the supraspinatus tendon. The exact cause is unknown, but tendon microtrauma and metabolic factors are thought to play a role. More common in 30-50 year old women. Its typical feature is characterized by very severe pain attacks (resorption phase).
Symptoms
The disease progresses in three phases:
- Formative phase: Usually painless, calcification forms slowly
- Resting phase: Mild complaints or quiet period
- Resorption phase: Very severe pain when body starts absorbing calcification; wakes from sleep, prevents arm movement
- In acute attack, local tenderness on superolateral shoulder
- Severely restricted arm movement (especially abduction)
- In some cases, shoulder swelling
Diagnostic Methods
Diagnosis is easy: X-rays clearly show calcification (evaluated as Garner type 1, 2, 3). Ultrasound shows calcification consistency and location, also evaluates accompanying pathologies (bursitis, tendon tear). MRI is performed in unclear cases.
Treatment Approach
Non-Surgical Treatments
80-90% of cases heal without surgery. In acute pain phase: strong painkillers, NSAIDs, subacromial cortisone injection (very effective), ice application, arm rest. Barbotage (US-guided needle breakdown and aspiration of calcification) is very successful. ESWT (shock wave therapy) helps in some cases.
Surgical Treatment
Surgery is needed for cases not benefiting from 6-12 months of conservative treatment with large calcification seriously affecting function. Arthroscopic calcification removal (calcification excision) is the gold-standard surgical method; accompanying pathologies (subacromial bursitis, tendon defect) are repaired in the same session.
Surgical Process
Performed under general anesthesia + interscalene block, patient in lateral position. 2-3 portals for arthroscopic intervention. Procedure lasts 45-60 minutes.
Hospital Stay
Most cases allow same-day discharge or 1 overnight.
Recovery Process
- First week: Arm sling, pain control, passive exercises
- Weeks 1-3: Active-assisted exercises
- Weeks 3-6: Active exercises, physical therapy
- Weeks 6-12: Strengthening, return to full activity
Return to Work
Desk work in 1-2 weeks, light physical work in 3-4 weeks, heavy work in 6-12 weeks.
Potential Complications
Complication rate is low. Possible problems: frozen shoulder development (especially in diabetics), calcification recurrence (rare), infection (very rare), nerve injury.
Frequently asked questions
Does calcification resolve on its own?
Yes, in the vast majority of cases, the body absorbs calcification over time (months to years) and the disease self-resolves. The process is painful but manageable conservatively.
What is barbotage?
A procedure where calcification is broken down and aspirated with a special needle under ultrasound guidance. 75-90% success rate provides rapid relief in acute phase.
Will the other shoulder also be affected?
Can affect the opposite shoulder in 10-25% of cases. Usually appears years after the first shoulder heals.
This content is for information only and does not replace examination, diagnosis or treatment. The right treatment for you is decided after an examination.