Medicines for Calcific tendinitis

What it is

Calcific tendinitis is a condition in which calcium deposits build up within a tendon, most commonly in the tendons of the shoulder (the rotator cuff). The reason the calcium deposits form is not fully understood, but they can cause pain and reduced movement. A characteristic feature is that the condition can go through phases: sometimes the deposits are present but cause few symptoms, while at other times — particularly when the body is breaking a deposit down (the "resorptive" phase) — it can cause sudden, intense, severe shoulder pain that can be very distressing, along with limited movement. Between flare-ups, there may be milder aching or no symptoms. It most commonly affects adults in middle age, and is more common in women, and (in the shoulder) can sometimes be associated with, or mistaken for, other causes of shoulder pain. Interestingly, calcific tendinitis often resolves on its own over time, as the body reabsorbs the calcium deposits, though this can take months and the acute phase can be very painful. Because shoulder pain has several causes, and because treatments can help, it is assessed (often with imaging, which shows the calcium deposits).

How it is treated

Management aims to relieve the pain and support the natural resolution of the condition, and most cases improve, often without needing more invasive treatment. In the acute, very painful phase, treatment focuses on pain relief — with anti-inflammatory painkillers (where suitable), and sometimes a steroid injection into the shoulder, which can significantly reduce the severe pain and inflammation. Physiotherapy helps maintain and restore movement and function, particularly as the acute pain settles. Because the condition often resolves on its own as the body reabsorbs the calcium, conservative management and time are frequently all that is needed. For deposits that are persistent and continue to cause significant pain despite these measures, other treatments target the calcium deposit directly — such as a procedure to break up or remove the deposit (for example needling or aspiration of the deposit under imaging guidance, or shockwave therapy), and, occasionally, surgery. Any associated shoulder problem is managed. The reassuring message is that calcific tendinitis, though it can cause very severe pain during flare-ups, often resolves on its own over time as the body reabsorbs the calcium, and that pain relief, injections, physiotherapy, and, for persistent cases, procedures to treat the deposit can all help.