What is Calcific Tendinitis? Symptoms and Treatment

Although calcific tendinitis is usually seen in the shoulders, it can also be seen in the knee, wrist, elbow and ankle. Accumulating calcium crystals cause inflammation and chronic destruction over time. The buildup in the tendons can cause pressure build-up and severe pain. Calcific tendinitis, which is seen in 3-5% of the population, does not show any symptoms in almost half of the cases.

What is Calcific Tendinitis?

Calcific Tendinitis is a polymorphic disease caused by the deposition of calcium crystals in tendons and ligaments. Calcium can accumulate in one area or occur in more than one place. Calcific tendinitis is seen in individuals between the ages of 30-60, more frequently in the female gender. There may be an underlying endocrine problem. Although the exact cause of the disease is not known, recurrent microtraumas and internal problems such as diabetes-hypothyroidism increase the incidence of the disease.

What are the Symptoms of Calcific Tendinitis?

About 80% of people with calcific tendinitis may not have any distinguishing symptoms. One of the most common complaints of patients is shoulder pain. In some patients, severe pain can cause insomnia and limit the movement of the arms. Since calcific tendinitis can also be seen in other joint areas, pain may occur in places where calcium deposits are present. The pain may appear suddenly, or it may develop gradually and increase gradually. Not all patients with calcific tendinitis have the same symptoms. Patients may develop different symptoms:

• Sudden shoulder pain or stiffness
• Severe pain with shoulder movement
• Severe pain that disrupts sleep
• Reduced range of motion
• Rotator cuff tenderness

How Does Calcific Tendinitis Occur?

Calcific tendinitis, which is usually seen in the shoulder, has 2 types: degenerative and reactive calcification. :

Degenerative Calcification:Due to aging, there is a decrease in blood flow to the tendons of the rotator cuff. This reduction causes the tendons to weaken. Weakened tendons can tear easily, like a frayed thread, with use, strain or minor trauma to the shoulder. The body creates calcium deposits in these areas to repair damaged tendons.

Reactive Calcification: Although there is no definite information about why reactive calcification occurs, researchers think that reactive calcification occurs in 3 stages.

Pre-calcification (Pre-calcification): This is the earliest stage. It is usually asymptomatic. At this stage, cellular changes occur in the areas where calcium accumulates.

Calcific phase: Calcium is released from the cells and forms calcium deposits. Calcium crystals accumulating in the tendons are reabsorbed by the body after a while. This stage can cause severe pain.

Postcalcification (Postcalcific stage): Calcium crystals reabsorbed from tendons leave their place to healthy tissues and healing occurs. With the new tissue, pain decreases and mobility is restored.

What Causes Calcific Tendinitis?

Calcific tendinitis occurs for various reasons:

• Aging
• Wear and tear
• Shoulder traumas
• Genetic predisposition to calcium deposition
• Sudden and compulsive movements
• Immobility
• Diabetes
• Hypothyroidism

How is Calcific Tendinitis Diagnosed?

Calcific tendinitis is showing symptoms and your complaint is for a long time. If it doesn't go away, you should definitely see a doctor. First, your doctor will evaluate your symptoms and medical history. Then he does a physical examination. After a physical exam, he or she may order certain imaging tests such as x-rays, magnetic resonance imaging (MRI), and ultrasound to diagnose any calcium deposits or other possible abnormalities. Since rheumatic diseases may also cause the formation of calcific tendinitis, laboratory tests may also be required.

How to Treat Calcific Tendinitis?

Treatment of calcific tendinitis differs according to the severity, duration and region of the symptoms. About 90% of calcific tendinitis cases can be controlled with medication or physical therapy without the need for surgery. Treatment methods that can be applied for calcific tendinitis are as follows:

Drug treatment Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen can be used in the treatment of calcific tendinitis. During your treatment, the drugs should be used in the dose recommended by your doctor. Cortisone injections may be given to relieve pain or swelling. lir.

Non-surgical treatments In mild to moderate cases, your doctor may recommend one of the following procedures. These conservative treatments can be performed without any anesthesia or pre-preparation. /li>

Radial shockwave therapy (RSWT): This therapy is similar to extracorporeal shockwave therapy. However, it is applied with a different technique.

Llavage treatment: In this treatment, the physician injects a sterile saline solution directly into the calcium deposit after local anesthesia is applied. Saline breaks down calcium crystals, reducing deposits. With application, it can reduce the pressure in the tendon, which can reduce the pain.

Therapeutic ultrasound: Calcium crystals are broken up with a high frequency sound wave. The procedure is painless.

Physical therapy: Moderate or severe cases require physical therapy to help restore your range of motion. Application of ice or heat throughout the treatment reduces pain and inflammation.

Surgical treatment Depending on the severity of calcific tendonitis, only 10% of cases may require surgical intervention. The operation is performed open or closed depending on the doctor's preference and the size of the calcific tendinitis. In open surgeries, an incision is made in the area of ​​calcium deposits and calcium crystals are removed. In operations where arthroscopic surgery is preferred, a small incision is made in the relevant area and the calcium deposit, which is viewed with the support of a camera, is removed with the help of surgical instruments. After the operation, the physician may recommend wearing a sling for a period of time to support and/or protect the shoulder. Your recovery time after surgery depends on the size, location and number of calcium deposits. Recovery time also varies from person to person. However, patients can usually return to their normal lives one week after the operation. In some cases, full recovery may take up to 3 months.

Recommendations to Prevent Calcific Tendinitis

Calcific tendonitis can be easily treated with exercise or medications, or it can cause serious conditions that require surgical intervention. physical activity in a person's daily life Paying attention to the following precautions can significantly prevent the formation of calcific tendinitis:

• Especially activities that cause overload on tendons should be avoided.
• When pain or burning is felt in the tendons during exercise, the movements should be interrupted immediately.
• The same sportive activities or exercise programs may not be suitable for everyone. A suitable sports and exercise plan should be created for the person.
• After training, warm-up and cool-down movements should be done to rest the muscles.
• Working environment (chair, table, keyboard) in situations that require sitting at the desk for a long time , mouse) should be in ergonomics that will make the person comfortable.

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