A calcium deposit, or calcification, is the abnormal accumulation of calcium salts, primarily calcium phosphate, in soft body tissues where they do not normally belong. This process causes the affected tissue to harden and can occur anywhere in the body, including tendons, arteries, and organs. While calcium is necessary for strong bones, its inappropriate deposition can disrupt normal function and cause pain or medical complications. The strategy for removing a calcium deposit depends heavily on its location, size, and underlying cause.
Causes and Common Locations of Calcification
Calcium deposits form through two primary biological mechanisms, categorized by whether the body’s overall calcium metabolism is normal or imbalanced. Dystrophic calcification is the more common type, occurring in tissue that has been previously damaged, degenerated, or necrotic. This process happens even when serum calcium levels are normal, often as a response to chronic inflammation, injury, or aging. A frequent example is calcific tendinitis, where deposits form in the rotator cuff tendons of the shoulder following repetitive stress.
The second type, metastatic calcification, involves the deposition of calcium salts in otherwise healthy tissues due to a systemic imbalance in calcium or phosphate levels. This condition is often a sign of an underlying medical issue, such as hyperparathyroidism, kidney failure, or certain vitamin D disorders that lead to elevated serum calcium (hypercalcemia). Common locations include the soft tissues of the shoulder, breast tissue, the kidneys (forming stones), and the walls of arteries. Vascular calcification contributes to the hardening of arteries and increases the risk of heart disease.
Conservative Management Strategies
The initial approach to managing symptomatic calcium deposits focuses on conservative strategies that do not involve physically removing the deposit. These treatments aim to reduce pain and inflammation, allowing the body time to naturally resorb the calcium, which often happens spontaneously. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are frequently used to control the acute pain associated with the deposit.
Physical therapy is often incorporated to maintain or restore the range of motion in affected joints, especially in cases of calcific tendinitis. Therapists guide patients through exercises designed to stretch and strengthen surrounding muscles. When pain is severe, a physician may administer a corticosteroid injection directly into the area to deliver an anti-inflammatory effect, providing relief and aiding rehabilitation.
Active Medical and Surgical Removal Procedures
When conservative management fails after several months, or when a deposit is large and severely limiting function, active procedures designed to break up or extract the calcium are considered. Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive technique that uses high-energy sound waves directed at the deposit. These focused shock waves cause the calcium material to fragment into smaller particles that the body can absorb and eliminate.
Percutaneous needle lavage, sometimes called barbotage, is a minimally invasive technique performed under ultrasound guidance. This procedure involves inserting two fine needles into the deposit: one to inject a sterile saline solution to break down the material and the other to aspirate the resulting calcium slurry. Needle lavage is highly effective for soft deposits, and recovery is typically faster than with surgery.
Surgical excision remains the most definitive option for refractory or very large deposits that have not responded to other treatments. Arthroscopic surgery is the preferred method for joints, such as the shoulder, using small incisions, a camera, and specialized instruments to visualize and physically remove the calcium. For extensive deposits in soft tissues like the skin (calcinosis cutis), an open surgical excision may be necessary. Surgery is generally reserved for deposits that are persistently painful, functionally limiting, or associated with complications like tendon tears.
Preventing the Formation of New Deposits
Long-term strategies to prevent recurrence involve addressing the underlying systemic factors that contribute to calcification. For individuals with metastatic calcification, managing conditions like chronic kidney disease or hyperparathyroidism is paramount to re-establish a healthy mineral balance. Regular monitoring of serum calcium and phosphate levels helps guide medical therapy to control systemic causes.
Dietary and lifestyle adjustments play a supportive role, particularly in reducing the risk of vascular and renal calcification. Adequate hydration is an effective measure for preventing kidney stones, as it ensures minerals are flushed out. Maintaining a heart-healthy diet that limits processed foods and excessive sodium can also help reduce the risk of arterial wall damage.
Specific micronutrients, such as magnesium and Vitamin K2, are recognized for their role in modulating calcium metabolism. Magnesium helps balance calcium levels and may help reduce buildup in arteries, while Vitamin K2 is thought to help direct calcium to the bones, preventing deposition in soft tissues. It is important to discuss any changes to diet or supplementation with a healthcare provider.