Calcific Tendinopathy
Calcific tendinopathy occurs when a calcium deposit forms inside a rotator cuff tendon. The deposit may be found by chance and cause no symptoms, or it may produce gradual discomfort or a sudden severe flare as the body begins to absorb it.
Common causes and risk factors
• The exact cause is not fully understood
• Changes in tendon cells and healing
• Most common in adults aged roughly 30-60
• Not usually caused by dietary calcium
Symptoms and signs
• Sudden severe or gradually increasing shoulder pain
• Night pain
• Pain lifting the arm
• Temporary marked stiffness
How is it diagnosed?
X-rays usually show the calcium deposit clearly. Ultrasound can identify its location and consistency and can guide treatment. Examination also checks for frozen shoulder or rotator cuff weakness.
Treatment options
Initial treatment includes pain relief, temporary activity modification and physiotherapy. Persistent symptoms may be treated with ultrasound-guided needling and lavage (barbotage), sometimes with an injection, or shockwave therapy. Keyhole removal is considered when symptoms remain significant despite less invasive care.
When should I see a specialist?
Arrange an assessment if you have:
• Severe pain that is not controlled
• Marked loss of movement
• Symptoms persisting despite rehabilitation
• Uncertainty about whether the deposit explains the pain
Frequently asked questions
Will the calcium disappear?
It may shrink or be absorbed naturally, although the timing is unpredictable.
Is it caused by too much calcium in my diet?
No. Dietary calcium is not considered the usual cause.
Does shockwave therapy always work?
No. Evidence suggests it may help some patients, but results vary and the best protocol remains uncertain.
What does the evidence say?
The evidence reveals that this is a self-limiting condition although the time required to recover is unpredictable. Treatment should be individualised.
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