Suffering from shoulder pain? Lime deposits may be the cause

The symptoms associated with calcium in the tendon depend on the stage of the condition. Many people have no symptoms in the early stages. It is only when the body actively tries to reabsorb the calcium - in the so-called resorption phase - that symptoms usually arise. Typical symptoms are:

Sudden, stabbing or burning pain in the shoulder

Night pain (unable to lie on shoulder)

Difficulty lifting or reaching

Limited mobility, especially when lifting the arm

Sometimes radiation to the upper arm or neck

These complaints sometimes resemble those of a bursitis or tendon irritation, but are caused by a different mechanism: a accumulation of calcium in the tendon itself. When in doubt, further examination, such as ultrasound or X-ray, is needed to make the correct diagnosis.

A reliable way to make this diagnosis is through ultrasound examination or a X-ray. In these images, calcification in the tendon is clearly visible.

At Physio Fitaal, we use musculoskeletal ultrasound, which allows us to immediately and reliably assess whether there is calcification in the tendon. This helps to initiate targeted treatment.

Ultrasound diagnosis and examination - Physio Fitaal

Calcific tendinitis proceeds in a recognisable and natural pattern in most cases. In doing so, the body goes through three phases: from build-up to breakdown, followed by recovery. Each phase has its own characteristics and requires a different approach in treatment.

Formation phase (1 to 6 years)

In this phase, the calcium gradually builds up in the tendon. The exact cause is not entirely clear, but we suspect that the body overreacts to minor damage in the tendon tissue. The calcium is slowly deposited in the tendon, without you even noticing. Many people spend years in this phase without complaints. Sometimes the calcification is discovered only by chance during an ultrasound or X-ray for something else.

Resorption phase (1 to 6 months)

At some point, the body starts to break down the calcium again. This sounds positive, but it is precisely at this stage that most symptoms arise. This is because the breakdown of calcium is accompanied by an inflammatory response. This is a natural response but annoying. This can cause intense, stabbing or burning pain in the shoulder, often occurs suddenly and is especially present at rest or at night. Sleeping on the affected shoulder often becomes difficult and movements above shoulder height can be painful or even impossible. This phase is usually temporary, but can last for weeks to months.

Recovery phase

After most of the calcium is cleared away, the shoulder enters a recovery phase. The inflammation subsides, the pain diminishes and the function of the tendon begins to recover. Still, the shoulder may remain stiff or sensitive for some time.

The treatment of calcium in the shoulder depends on the symptoms and the phase you are in. In the painful phase, we usually start with anti-inflammatory drugs (NSAIDs) and advise relative calm with temporarily avoiding movements above shoulder height. At this stage, it is important to get back to calm as said, but the shoulder is certainly allowed to move within pain limits.

Once the pain subsides, at Physio Fitaal we turn to targeted physiotherapy, focusing on overall shoulder function and start exercises below 90 degrees, built up gradually towards strength and greater function. The build-up is always done according to what is possible and what the shoulder allows.

For persistent or intractable complaints, we can apply complementary techniques aimed at influencing the calcification and stimulating the body's natural repair process. These treatments focus specifically on accelerating the breakdown of calcium, with the aim of pain reduction and restoration of function. Depending on the situation, we choose the most appropriate method here, tailored to the size, location and stage of calcification.

In most cases, surgery is not necessary, but in the case of large or persistent calcium deposits that do not respond adequately to conservative therapy, additional medical interventions may be considered. Especially when the deposit is larger than 1 cm, there is an indication for further intervention. One such option is a barbotage procedure, in which the calcification is punctured with a needle under ultrasound guidance and gently flushed out. This can relieve pressure on the surrounding tissue and reduce the inflammatory response. In some situations, a injection of an anti-inflammatory drug (corticosteroid) provide temporary relief, especially in severe pain or an active inflammatory phase.

Only if these less invasive treatment options do not have the desired effect, can a orthopaedic surgeon decide to operate, where the lime during a keyhole surgery (arthroscopy) is carefully removed. This is always done by mutual agreement and usually only after other treatment methods have been tried and have yielded insufficient results.

Yes, in most cases it does. Calcific tendinitis is a condition where the body eventually tries to clear out the calcium itself. That natural recovery process can take weeks to sometimes several months, and unfortunately is not always without symptoms. The degree of pain and duration of recovery can vary greatly from person to person.

With a timely diagnosis, appropriate guidance and complementary therapies such as targeted physiotherapy or techniques that stimulate recovery, for example, symptoms can often be resolved within 3 to 6 months clearly improve.

At Physio Vital we have extensive experience treating people with calcium deposits in the shoulder. Thanks to the use of ultrasound, we can quickly and accurately determine what is going on - and immediately start an effective approach that suits your recovery phase.

Think your shoulder pain may be caused by calcium in the tendon? Then schedule an intake or ultrasound assessment with one of our specialists. We will help you with a clear diagnosis and a targeted treatment plan.

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