Calcified shoulder (tendinitis calcarea)
Acute care & follow-up treatment
ÜBERSICHT
What is a calcified shoulder?
Calcified shoulder (tendinosis calcarea) is caused by calcium deposits in the tendons of the rotator cuff (usually the supraspinatus tendon), which surround the shoulder like a cuff. The calcium deposits are caused by a regional lack of blood supply and prolonged overloading of the tendons.
Typical phased course:
- Remodeling of the tendon tissue and calcification.
- The formation of the calcium deposit leads to the development of a shoulder impingement
- Prolonged resting phase without significant symptoms which can last for years.
- Independent dissolution of the calcified focus which can cause irritation of the bursa (= subacromial bursitis) with subsequent pain, often at night.
- The pain disappears again once the calcium has broken down. This can result in shoulder stiffness with restricted movement.
How does a calcified shoulder manifest itself?
Pain usually occurs when lying down and at night. With increasing strain, especially after overhead work, the symptoms become more noticeable. The pain can lead to complete restriction of movement in the affected shoulder (= pseudoparalysis).
How is a calcific shoulder diagnosed?
X-rays usually show a cloud-like compaction in the tendon area. The focus can also be seen in ultrasound examinations (sonography) and magnetic resonance imaging (MRI).
How is a calcific shoulder treated?
Physiotherapy exercises to balance the rotator cuff are essential, also to treat the cause of the one-sided overload. The pain often leads to incorrect posture, which in turn leads to tension in the neck and shoulder muscles. Targeted stretching exercises and massage techniques can release these and lead to an improvement in the symptoms.
Conservative treatment of painful bursitis with anti-inflammatory medication and Cortision infiltrations usually leads to very good results. Dry needling” attempts to puncture the calcified focus with a needle in order to accelerate the emptying of the focus.
Shock wave therapy, where the calcification is treated using high-frequency ultrasound, also shows good results.
In chronic, frustrating cases, surgical arthroscopic removal of the calcification can be considered. This involves mechanically removing the calcification and suturing the rotator cuff in the case of larger tendon defects.
