Calcific Tendinitis of the Shoulder

Overview

Calcific tendinitis happens when deposits of calcium form inside one of the rotator cuff tendons — most often the supraspinatus, the tendon that runs over the top of the shoulder. Nobody fully understands why it happens, but it is not related to diet or to how much calcium you eat.

The deposit often sits quietly for a long time and may be found by chance on an X-ray. Pain tends to appear in two ways. Some people have a long, grumbling ache with a painful arc on lifting the arm, similar to other rotator cuff problems. Others experience a sudden, severe attack — often when the body starts to break the deposit down — with pain so intense that any movement is agony, sleep is impossible, and the shoulder may feel warm. This acute phase is frightening but usually settles over a couple of weeks as the calcium is reabsorbed.

It is most common between 30 and 60, more often in women, and tends to affect the dominant arm. Many cases eventually resolve on their own, but this can take a long time, and treatment aims to reduce pain and speed the process along.

Causes and risk factors

• Age 30–60, female
• Diabetes and thyroid disorders
• Repetitive overhead use of the shoulder
• Possibly reduced blood supply to the tendon
• Not caused by dietary calcium or supplements

How we may be able to help

Because calcific tendinitis can look like other shoulder problems, we assess carefully and, if a deposit is suspected, can arrange an online GP consultation for an X-ray or ultrasound scan to confirm it and measure its size.

Focused shockwave therapy is one of the most studied treatments for this condition. The acoustic pulses are directed precisely at the deposit, and evidence suggests this can help break it down, reduce pain and improve movement in many people. A course usually involves several sessions a week or so apart, following your initial assessment.

Alongside shockwave, physiotherapy keeps the shoulder moving and restores strength once the acute pain settles — stiffness can set in quickly if the arm is held still, and a weak cuff makes recurrence more likely. In the acute phase, interferential therapy may ease pain, and we can advise on positioning for sleep. Cupping and IASTM can help the surrounding muscles that tighten up protectively.

If the deposit is very large, or pain remains severe despite treatment, we can arrange a specialist opinion through our online GP service.

What you can do at home

• During a severe flare, rest the arm in a comfortable position and apply ice for 10–15 minutes at a time
• As soon as pain allows, start gentle pendulum swings and assisted lifts to prevent stiffness
• Sleep propped up slightly, with the arm supported on a pillow
• Avoid overhead lifting and carrying on the affected side until advised
• Keep a note of what triggers pain to share with your therapist
• Do not change your diet or stop calcium supplements — they are not the cause