Calcific Tendinopathy Treatment & Rehabilitation

What Causes Calcific Tendinopathy?

The exact reason calcium deposits develop within rotator cuff tendons is not fully understood. The condition is different from simply having “wear and tear” in the shoulder.

Calcific tendinopathy most commonly affects adults in middle age and can develop without any obvious injury.

The calcium deposit may remain relatively quiet for a period of time or become associated with pain and inflammation, sometimes quite suddenly.

What Does Calcific Tendinopathy Feel Like?

Symptoms vary considerably. Some people have calcium deposits without experiencing any pain, while others develop significant symptoms.

Possible symptoms include:

• Shoulder pain when lifting the arm
• Pain around the outside or front of the shoulder
• Pain when reaching overhead
• Difficulty lying on the affected shoulder
• Reduced shoulder movement
• Weakness caused by pain
• Difficulty dressing, lifting or exercising

In some cases, pain can become severe over a relatively short period of time.

Is Calcific Tendinopathy the Same as Shoulder Impingement?

No. Calcific tendinopathy refers specifically to calcium deposits within a rotator cuff tendon.

However, the symptoms can overlap with other forms of rotator cuff-related shoulder pain, including what has traditionally been called shoulder impingement.

You can read more about this on our Shoulder Impingement & Rotator Cuff Pain page.

How Is Calcific Tendinopathy Diagnosed?

Diagnosis is based on your symptoms, medical history, examination and, where appropriate, imaging.

Your assessment may include:

• Active and passive shoulder movement
• Rotator cuff strength
• Movements that reproduce your pain
• Shoulder blade movement
• Examination of the neck and upper back where appropriate

Because calcium deposits are visible on X-ray, imaging may sometimes help confirm the diagnosis. Ultrasound can also be useful in assessing the rotator cuff and the size and location of a deposit.

Imaging findings should still be interpreted alongside the clinical examination because calcium deposits can sometimes be present without causing symptoms.

How Is Calcific Tendinopathy Treated?

Treatment depends on the severity and duration of symptoms, the effect on shoulder function and the findings from the examination.

Management may include:

• Advice about temporarily modifying painful activities
• Exercises to maintain or restore shoulder movement
• Progressive rotator cuff strengthening
• Exercises for shoulder blade control
• Mobilisation or manual treatment where restricted movement is contributing
• Progressive return to normal activity

The aim is to reduce pain, improve movement and gradually restore the shoulder’s ability to tolerate everyday activity, work and exercise.

Can Shockwave Therapy Help Calcific Tendinopathy?

Shockwave Therapy may be considered for some people with persistent calcific rotator cuff tendinopathy.

It uses externally applied acoustic waves and may help reduce pain and support remodelling of the calcific deposit and surrounding tendon tissue.

Shockwave is generally considered as part of a broader treatment and rehabilitation plan rather than as a stand-alone treatment.

What About Laser or TECAR Therapy?

Depending on the individual presentation, we may sometimes use Low Level Laser Therapy or TECAR Therapy alongside exercise and rehabilitation where appropriate.

These treatments are not suitable for every case and should not replace progressive rehabilitation.

Does Calcific Tendinopathy Always Need Treatment?

No. Calcium deposits can sometimes be present without causing symptoms and may not require treatment.

Treatment is more relevant when the clinical findings suggest that the deposit is contributing to pain, restricted movement or reduced shoulder function.

How Long Does Calcific Tendinopathy Take to Improve?

Recovery varies considerably. Some episodes settle relatively quickly, while persistent cases may take longer to improve.

The time course depends on factors such as the size and stage of the deposit, how long symptoms have been present, shoulder strength and movement, and the demands placed on the shoulder.

We therefore monitor pain, movement, strength and function and adapt treatment and rehabilitation according to progress rather than promising improvement within a fixed period.

When Should Calcific Tendinopathy Be Investigated Further?

Further investigation may be appropriate if the diagnosis is uncertain, symptoms are severe or persistent, there is marked weakness, significant loss of movement or progress is not occurring as expected.

You should seek prompt medical advice if shoulder pain is accompanied by severe swelling, redness, fever or feeling seriously unwell.

Chest pain, breathlessness, sweating or unexplained pain spreading into the arm or jaw requires urgent medical attention.

Calcific Tendinopathy and Shoulder Pain Treatment

Calcific tendinopathy is one possible cause of shoulder pain. You can read about other causes, assessment and treatment options on our Shoulder Pain Treatment & Chiropractic Care page.

If you would like an assessment, chiropractic care is available at our
Milton Keynes Chiropractic Clinic,
Northampton Chiropractic Clinic and
Aylesbury Chiropractic Clinic.

What Happens at My First Appointment?

We will discuss your symptoms, how they developed, the activities that aggravate the shoulder and your medical history before examining the shoulder.

Where appropriate, we may assess the neck and upper back and consider whether imaging would be useful in confirming the diagnosis.

We will explain what we think may be contributing to your symptoms and discuss treatment and rehabilitation options. If further investigation or medical referral would be more appropriate, we will explain this and advise you on the next step.