What are shoulder calcifications?

Shoulder calcifications correspond to calcium deposits within tendons, most often the supraspinatus. These deposits are responsible for acute pain and significant functional limitations.

Calcifying tendinopathy evolves by sometimes very intense flares and requires adapted management according to the evolutionary phase and the importance of symptoms.

Natural evolution and phases

Formation phase

Progressive calcium deposit in the tendon, often asymptomatic or slightly painful.

Rest phase

Stabilization of calcium deposits, generally slightly symptomatic.

Resorption phase

Resorption of calcifications, often the most painful phase with inflammatory flares.

Favoring factors

Demographic factors

Typical age of 30-50 years, with female predominance. Calcifications can be bilateral in some cases.

Metabolic terrain: Certain metabolic disorders may favor calcification formation.

Microtrauma

Repeated shoulder stress, professional or sports activities above the head may favor calcification appearance.

Spontaneous regression: Many calcifications regress spontaneously without specific treatment.

Symptoms and manifestations

Pain

Acute pain, sometimes nocturnal, with very intense inflammatory flares. Pain can be disabling and wake up at night.

Characteristics: Often sudden, intense pain, with significant limitation of shoulder mobility.

Functional limitation

Significant limitation of arm elevation, difficulties for daily gestures and professional activities.

Impact: Significant reduction in quality of life and functional performance.

Diagnosis and evaluation

Clinical examination

• Pain on palpation: Localized sensitivity at supraspinatus tendon level
• Mobility limitation: Restriction of elevation and abduction movements
• Specific tests: Rotator cuff tests often positive

Imaging examinations

X-rays

Reference examination to visualize calcifications and assess their size and location

Ultrasound

Minimally invasive examination to assess inflammation and tendon vascularization

MRI

Reference examination in case of diagnostic doubt or for surgical planning

Therapeutic options

Conservative treatment

Conservative treatment is preferred as first intention and can be effective in many cases.

• Medications: Analgesics and anti-inflammatories to control pain
• Injections: Corticosteroid injection into subacromial space
• Shock waves: Treatment by extracorporeal shock waves
• Lavages: Percutaneous lavages under ultrasound
• Physiotherapy: Mobilization and progressive strengthening

Surgical treatment

Arthroscopic calcification evacuation is indicated in case of failure of well-conducted conservative treatment.

Surgical indications:

• Disabling pain persisting despite ≥ 3–6 months of conservative treatment
• Large calcification with associated subacromial impingement
• Recurrence of acute flares with work stoppage or major discomfort

Arthroscopic evacuation

Intervention performed under arthroscopy allowing evacuation of calcifications and treatment of associated lesions. This minimally invasive technique offers excellent results.

Advantages: Minimally invasive technique, rapid recovery, excellent functional results.

Learn more about acromioplasty →

Post-operative rehabilitation

Rehabilitation after calcification treatment is essential to optimize functional recovery and prevent recurrences.

Phase 1: Pain control (0-2 weeks)

Pain control, passive and assisted mobilizations to maintain mobility

Phase 2: Range recovery (2-6 weeks)

Progressive recovery of movement ranges and gentle strengthening

Phase 3: Strengthening (2-3 months)

Progressive strengthening and return to overhead gestures

Return times: Progressive sports return after 8-12 weeks depending on evolution.

Possible complications