Many patients visiting the hospital for calcific tendinitis come in with their arms immobilized. 

 

The pain is so severe that it is impossible to move even a little, and it is often described as "pain never felt in a lifetime." Calcific tendinitis of the shoulder, which causes such extreme pain, is a condition where calcium deposits, called calcifications, accumulate in the shoulder tendons, leading to inflammation.

This pain has the characteristic of appearing suddenly overnight.

 

In cases of other shoulder conditions such as frozen shoulder or rotator cuff tears, if symptoms worsen over time, calcific tendinitis can suddenly cause pain, leading to suspicion of a serious condition and sometimes prompting a visit to the emergency room.

Silent calcific tendinitis progresses through three stages: the formative stage where calcification begins, the resting stage where it hardens like chalk, and the resorptive stage where it is in a semi-solid state like toothpaste. The most pain occurs during the resorptive stage, when the calcification is absorbed into the body.

 

In the case of a quiescent period, the calcified form is clearly visible and can be easily confirmed through ultrasound examination. However, when absorption or tendon rupture is accompanied, it is difficult to make an accurate diagnosis with ultrasound alone, and it is advisable to make a comprehensive assessment using MRI.

Calcific tendinitis is ultimately absorbed by the body, so non-surgical treatment is prioritized. Medication and injection therapies are used to help pass through the period of severe pain. Extracorporeal shock wave therapy, which helps break down the calcification into smaller pieces, is also effective. If the calcification is large, local anesthesia is administered, and under ultrasound guidance, a needle is inserted to create a small hole in the tendon to facilitate absorption and drainage.

 

If calcium deposits do not drain despite consistent non-surgical treatment or are too large, and severe pain that impairs daily life persists, surgical treatment may be considered. This involves making a small incision to insert an arthroscope, removing the calcium deposits, and treating the damaged tendons. Endoscopic surgery, which can be performed with a minimal 1cm incision, minimizes unnecessary muscle damage, results in less pain, and allows for a quicker return to daily activities, thereby reducing the burden of surgery.

 

Calcific tendinitis is a condition that does not require treatment if there are no specific symptoms. However, if symptoms are present and left untreated, secondary conditions such as frozen shoulder may develop, so it is advisable not to miss the appropriate timing for treatment. (Written by Dr. Bae Tae-yong, Orthopedic Specialist at Saengsaeng Hospital)

 

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Many people know shoulder pain as frozen shoulder.

Calcific tendinitis. Visit the hospital if you have shoulder pain.

 

It would be best to first conduct an examination to determine the cause.

 

There are various types of shoulder pain.