Calcific tendonitis is a condition where calcium deposits form within tendons, often causing pain and limiting movement. While these deposits can occur in various parts of the body, they are most frequently found in the rotator cuff tendons of the shoulder. This buildup can lead to inflammation and significant discomfort.
Immediate Pain Relief and Conservative Care
Initial management of calcific tendonitis often begins with less invasive strategies aimed at reducing pain and inflammation. Resting the affected shoulder and modifying activities that aggravate the tendon can help alleviate symptoms. Applying ice packs regularly is beneficial for acute pain and swelling, while heat therapy can be more helpful for ongoing pain by increasing blood flow. Over-the-counter pain relievers, such as NSAIDs, can also be used to manage pain and reduce inflammation. Once acute pain subsides, gentle stretching and strengthening exercises are often recommended as part of physical therapy to improve the shoulder’s range of motion and promote overall tendon health.
Non-Surgical Therapies
When initial conservative care does not provide sufficient relief, healthcare professionals may recommend more targeted medical treatments. Extracorporeal Shockwave Therapy (ESWT) uses high-energy sound waves directed at calcium deposits. This therapy aims to break down the deposits and stimulate the body’s natural healing processes, proving effective for pain relief and successful calcification breakdown. Therapeutic ultrasound also uses high-frequency sound waves to reduce inflammation and may assist in breaking down calcium deposits, offering short-term clinical improvement. Advanced physical therapy focuses on specific exercises and manual techniques to improve shoulder mechanics and reduce stress on the tendon, restoring function and building tolerance to daily activities.
Image-Guided Procedures
Minimally invasive procedures involving needles, typically guided by imaging technology like ultrasound or fluoroscopy, represent a significant step in treatment before considering surgery. Ultrasound-guided percutaneous needling and lavage, also known as barbotage, involves inserting a needle under real-time ultrasound guidance to locate and break up calcium deposits. The process includes fragmenting the calcium, followed by flushing the area with a saline solution and aspirating the broken-down material, which is often effective in reducing pain and improving function. Corticosteroid injections deliver steroid medication directly into the affected area to reduce severe inflammation and pain. These injections primarily work by inhibiting inflammatory processes, providing significant pain relief, but they do not directly remove the calcium deposits themselves.
Surgical Intervention
Surgical options for calcific tendonitis are generally considered when other treatments have not provided sufficient relief. Arthroscopic removal is a minimally invasive surgical procedure where small incisions are made, and an arthroscope is used to visualize and remove calcium deposits. This technique offers advantages such as smaller incisions and often a faster recovery compared to traditional open surgery. While arthroscopic surgery is the more common approach, open surgery, involving a larger incision, may still be used in complex cases. Following surgical removal, recovery typically involves using a sling and engaging in physical therapy to regain range of motion, strength, and function, with arthroscopic recovery often quicker, though full recovery may take several months.