Rotator cuff calcific tendinitis, often referred to as rotator cuff calcification is a distinctive condition that appears to affect only the tendons of the cuff muscles. It is one of the most painful conditions to affect the shoulder. It is a condition that is closely related to rotator cuff tendonitis but it has distinct causes and treatments.
What is calcific tendinitis?
Calcific tendinitis relates to a build-up of calcium in the tendon; otherwise known as a calcific deposit. When calcium builds up in a tendon, it causes rotator cuff inflammation, a build up of pressure and causes a chemical irritation. This leads to pain and with this particular condition the pain can be quite intense.
In addition to the chemical irritation and pressure, the calcification process reduces the space available between the tendon and the acromion. This can lead to subacromial impingement.
Causes
Exactly why calcification occurs is still not well understood. Doctors and scientists can not agree on why the condition develops and why this condition only affects cuff tendons.
Most theories suggest that calcification is caused by lack of good blood flow to the tendon or increasing age; however there is no definitive scientific evidence to support either theory.
The Calcification process
What is known about calcification is that the condition follows a cycle. There are three distinct stages through which the condition progresses.
Pre calcification stage - The area in which calcium will be deposited begins to undergo cellular changes. These changes predispose the tendon to developing calcium deposits. No symptoms are felt at this stage.
Calcific stage - During this phase calcium is excreted from cells and forms the calcium deposit. Again no symptoms are generally detected at this time. There is then a distinct period when the deposit is re absorbed. This period is the most painful.
Post calcific stage - The calcific deposit begins to disappear and is replaced by more normal tendon.
Treatment
The treatment of rotator cuff calcific tendonitis follows a lot of the same basic methods as the treatment of tendonitis.
Rest
RICE
Anti Inflammatory and pain relieving medication.
Physiotherapy exercises
It is if the condition persists that further attention may be required. The other options available include:
Cortisone injection in an attempt to control the swelling and pain.
Ultrasound guided Lavage - The calcium deposit is injected with a salt water solution in an attempt to break it down. The residue is then sucked out using the syringe.
Surgery - A last resort. During surgery the calcium deposit is removed.
Thankfully rotator cuff calcific tendonitis is the least common of major the conditions affecting the rotator cuff.
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