Calcific shoulder tendinitis
Why did my shoulder suddenly become so painful I cannot lift my arm?
Calcium deposits in a rotator cuff tendon. They can cause sudden severe pain or long-standing aching.
What it feels like
Either a sudden onset of severe shoulder pain, often at night, that makes it very hard to lift the arm, or a longer-standing ache on the outside of the shoulder with pain reaching overhead.
What is actually happening
Calcium deposits form within a rotator cuff tendon, most often the supraspinatus. The very painful phase usually happens when the body is breaking the deposit down, and deposits often resolve on their own over time.
When to see a doctor
See a doctor promptly for severe shoulder pain with fever, redness or swelling, pain after a fall with inability to lift the arm, or shoulder pain with chest pain or shortness of breath.
How it is assessed
Assessment includes the onset and behaviour of pain, range of motion, rotator cuff strength, and screening of the neck and other causes of shoulder pain. The diagnosis is confirmed with imaging arranged by a physician.
How it is treated
A systematic review found that high-energy extracorporeal shockwave therapy improves pain and function in chronic calcific tendinitis of the shoulder, and can help the deposit resolve. Treatment combines pain relief and gentle movement in the acute phase with progressive rotator cuff and shoulder blade strengthening once pain settles. Physicians may also offer injection or ultrasound-guided procedures, and I can discuss referral if pain is not settling.
What to do first
In a severe flare, keep the shoulder moving gently within comfort, support the arm on a pillow at night, and see your doctor about pain relief. Have it assessed to plan treatment.
Where this is assessed
- Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
- Push Pounds Sports Medicine Downtown Toronto · Tue/Thu · 8:30 AM – 6:30 PM Call Push Pounds to book
References
This page is based on the following clinical practice guidelines and research.
- Bannuru RR, Flavin NE, Vaysbrot E, et al. High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review. Ann Intern Med. 2014;160(8):542-9.
- Lewis J. Rotator cuff related shoulder pain: Assessment, management and uncertainties. Man Ther. 2016;23:57-68.