Calcific tendonitis is a condition where calcium deposits form within tendons, most commonly affecting the rotator cuff in the shoulder. These deposits can lead to localized pain and a reduction in the affected joint’s range of motion. Understanding if and how this condition resolves naturally is a frequent concern for those experiencing its symptoms.
Understanding Calcific Tendonitis
Calcific tendonitis involves the accumulation of calcium phosphate crystals within a tendon. The precise cause of these deposits remains unknown, and their formation is not linked to injury, dietary factors, or osteoporosis. While the shoulder’s rotator cuff is the most frequent site, calcific deposits can also appear in tendons of the elbows, wrists, hips, knees, and feet.
Individuals with calcific tendonitis experience symptoms such as sudden or gradual pain, stiffness, and a reduced ability to move the affected area. Pain can intensify at night and the tendon may feel tender to the touch. Diagnosis involves a physical examination, followed by imaging tests like X-rays and ultrasound, with ultrasound being more sensitive for detecting these calcium formations.
The Body’s Natural Resolution Process
Calcific tendonitis can resolve on its own, a process that unfolds through distinct stages. Initially, in the precalcific stage, tendon cells undergo changes that make them receptive to calcium deposition, without causing any symptoms. This is followed by the calcific stage, which has two main phases.
During the formative phase of the calcific stage, calcium deposits begin to accumulate and appear uniformly dense on X-rays. This period is asymptomatic or associated with only mild pain. A resting phase may then occur where calcium deposition temporarily stops, remaining pain-free.
The most intense pain arises during the resorptive phase, when the body actively attempts to reabsorb the calcium deposits. During this phase, immune cells work to break down the deposits. The inflammation and pressure from this reabsorption process account for the heightened discomfort. This natural resolution process varies widely in duration, taking 6 to 9 months, but it can extend to 12 to 18 months for complete reabsorption. However, not all calcific deposits will spontaneously disappear.
When Intervention Becomes Necessary
While natural resolution is possible, it may not always be sufficient, leading to persistent or severe symptoms. Factors such as the size of the calcium deposit and the duration of symptoms can influence whether spontaneous resolution occurs. When the condition causes severe pain, prolonged discomfort, or significant limitations in movement, medical advice becomes appropriate.
Seeking a medical evaluation helps confirm the diagnosis and distinguish calcific tendonitis from other shoulder conditions. A healthcare provider can then determine the most suitable next steps if the natural course is not providing adequate relief.
Available Management Options
When calcific tendonitis does not resolve naturally or symptoms are severe, various management options are available. Initial non-surgical approaches include rest, ice application, and anti-inflammatory medications to manage pain and inflammation. Physical therapy focuses on restoring range of motion and strengthening surrounding muscles, rather than directly breaking down the calcium deposits.
Corticosteroid injections can be administered to reduce local inflammation and provide pain relief. Shockwave therapy utilizes acoustic waves to help fragment the calcium deposits and promote the body’s natural healing processes. Another non-surgical option is ultrasound-guided needle lavage, which uses a needle to remove calcium deposits. For cases unresponsive to conservative measures, surgical removal of the deposits may be considered. Recovery following surgical intervention takes about six weeks, involving a course of physical therapy.