Calcified shoulder (tendinosis calcarea) is a disease of the shoulder tendons, particularly the supraspinatus tendon. It can be caused by a reduced blood supply to the rotator cuff, which leads to calcium deposits in the supraspinatus tendon. However, there is almost always a transformation of tendon cells, which can then deposit calcium. When these cells transform and, above all, when they transform back again and shed the calcium is being researched.
The degree of strain on the shoulder and previous injuries or falls on the shoulder appear to be irrelevant. The majority of patients are between 40 and 50 years old.
The term calcific shoulder is often used as a collective term for inflammatory and wear-related changes in the shoulder. However, there are various other causes of these changes that should not be confused with calcific shoulder. The treatment recommendations of shoulder experts for calcific shoulder differ significantly from the treatment of other shoulder disorders.
In most cases, calcific shoulder occurs in middle age - between the ages of 30 and 50. Around 70% of affected patients are women. The condition is less common in older people. The exact causes of calcific shoulder have not yet been conclusively clarified scientifically. However, it is suspected that tendon cells are transformed into storage cells, which can then store calcium. Another theory is that the calcium comes from the bone and is formed where the supraspinatus and infraspinatus tendons attach to the upper arm. However, this is contradicted by the fact that there is no typical localization of the calcification in the tendon hood (rotator cuff).
If you have a sudden pain in a resting position or the pain gets worse with movement, this may indicate a calcific shoulder. Pain at night is typical and is difficult to treat.
Calcified shoulder is usually treated conservatively. Pain-relieving and anti-inflammatory medication and cooling of the shoulder relieve the pain and slow down the inflammatory processes. An injection with mild painkillers also leads to a rapid reduction in pain. Shock wave therapy can also alleviate recurring pain in the shoulder. This involves targeting the calcium deposit with energetic sound waves. The biological healing processes promoted by this dissolve the calcium deposits. The shoulder joint should be moved as soon as the pain in the calcified shoulder allows it. The physiotherapist will provide you with special exercises for this.
A good method is the ultrasound-targeted puncture of the calcium deposit with aspiration of the calcium. We use this method regularly.
In rare cases, surgery may be necessary if all conservative treatment methods have failed to relieve the pain over a long period of time, or if the pain keeps recurring and there is no improvement. However, there are usually other changes in the shoulder joint that have led to the pain or made it worse.
During the operation, the calcium deposits are removed and the space under the acromion is widened. This procedure is usually performed arthroscopically (minimally invasive). During the operation, additional damage (osteoarthritis, rotator cuff tear) can be diagnosed at the same time and treated if necessary.
Dr. Martin Schwarz, MSc, Prim. a.D.
Specialist for trauma surgery,
Specialist in Orthopedics and Traumatology Shoulder Center Vienna
Surgery for shoulder, knee and sports injuries