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Calcific Tendonitis - Shoulder Injury

This condition often presents dramatically and often with little cause for the onset of agonising shoulder pain. This is often so acute and severe that patients end up seeking advise from the emergency services.

The pain is in the same position as tendonitis with pain from the shoulder running into the upper arm as the condition is effectively the same. In calcific tendonitis the body deposits calcium in an attempt to heal the tendon. This is not related to calcium metabolism, so reducing your calcium intake will not help.

Initially the calcium is soft almost like toothpaste this is usually the most painful. During this phase injections and barbotage (a technique where the calcium can be removed under local anaesthetic) are often effective. Following these type of treatment physiotherapy is required to avoid the onset of a frozen shoulder. Diagnosis is confirmed by ultrasound which is more effective in picking up the calcium than an MRI.

Shock wave therapy is non invasive. This involves a series of treatment each week, for three weeks. This has been shown to be as effective as injections at reducing symptoms. I administer this in an outpatient setting. It takes about 15 to 20 minutes for each session.

Calcium deposit on x-ray

If these non surgical methods do not work then surgery maybe indicated. This in the first instance is by keyhole surgery. The calcium is probed to release it and the shoulder decompressed to prevent further episodes. This works in about 80% of patients although the recovery following surgery can take a number of months. We occasionally resort to open surgery but only if keyhole surgery has failed.

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