[Medical Column] Even raising your arm is difficult! What's the #1 cause of shoulder pain?

When patients come to the hospital with calcific tendonitis, many come in with their arms immobilized. 

 

The pain is so intense that it's impossible to move at all, and some describe it as "the worst pain I've ever felt in my life." Calcific tendonitis, which causes this excruciating pain, is a condition in which calcium deposits (calcium) accumulate in the shoulder tendons, causing inflammation.

This pain is characterized by its sudden onset overnight.

 

In the case of other shoulder diseases such as frozen shoulder and rotator cuff tear, the symptoms get worse over time, but in the case of calcific tendonitis, the pain appears out of nowhere, and people suspect a serious illness and go to the emergency room.

Calcific tendonitis progresses through three stages: the formation stage, when calcium deposits begin to form; the resting stage, when they harden like chalk; and the absorption stage, when they take on a semi-solid state like toothpaste. The absorption stage, where the calcium is absorbed into the body, causes the most pain.

 

In the case of a resting lesion, the calcification is clearly evident and can be easily confirmed with an ultrasound examination. However, in cases involving abscesses or tendon ruptures, an accurate diagnosis is difficult with ultrasound, so a comprehensive assessment using an MRI is recommended.

Because calcific tendonitis is ultimately absorbed by the body, non-surgical treatment is prioritized. Medication and injection therapy can help alleviate the intense pain. Extracorporeal shock wave therapy, which helps break up the calcium deposits, is also effective. For larger deposits, a needle is inserted under local anesthesia and ultrasound guidance to create a small hole in the tendon, allowing for absorption and drainage.

 

If persistent nonsurgical treatment fails to remove the calcium deposits, they are too large, or the pain persists to the point of disrupting daily life, surgical treatment may be considered. This procedure involves inserting an arthroscope through a small incision to remove the calcium deposits and repair the damaged tendon. This minimally invasive procedure, which can be performed through a 1cm incision, minimizes unnecessary muscle damage, resulting in less pain and a faster return to normal activities, alleviating the burden of surgery.

 

Calcific tendonitis typically doesn't require treatment if there are no specific symptoms. However, if symptoms are present and left untreated, secondary conditions like frozen shoulder can develop. Therefore, it's crucial to seek treatment promptly. (Article by Bae Tae-yong, Orthopedic Surgeon, Saengsaeng Hospital)

 

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Many people know that shoulder pain is caused by frozen shoulder.

Calcific tendonitis. If your shoulder hurts, visit a hospital.

 

It would be better to first check what the cause is.

 

Shoulder pain also comes in many different types.