Calcific tendinitis of the shoulder is a condition where calcium crystals deposit within a rotator cuff tendon — most commonly the supraspinatus. It affects roughly 3-8% of adults, most often between ages 30-60, and slightly more women than men.
The strange thing about it
Many people have calcific deposits that never cause pain. But when a deposit enters the "resorptive phase" — when the body starts to break it down — inflammation flares dramatically and the pain can be excruciating, often coming on without any injury or trigger.
The stages
- Pre-calcific — tendon changes begin, usually silent
- Calcific formation — deposit forms and grows, often mildly symptomatic or asymptomatic
- Resorptive — the body reabsorbs the deposit, and this is when pain is often at its worst
- Post-calcific — deposit is gone, tendon remodels
Symptoms
- Sudden, severe shoulder pain, often without a triggering injury
- Pain worse at night, often disturbing sleep
- Restricted range of motion, especially overhead
- Sometimes visible on X-ray as a chalky deposit within the tendon
The good news
Most calcific tendinitis eventually resolves on its own — the body does clear the deposit. But "eventually" can mean months, and the pain can be significant. Treatment can substantially shorten this timeline.
Our approach
Shockwave therapy has strong evidence for calcific tendinitis. It's one of our most effective interventions for this condition — the acoustic waves help break down deposits and stimulate resorption.
Ultrasound-guided needling and lavage is done by radiologists for larger, painful deposits.
Manual therapy to restore lost range of motion and maintain surrounding tissue health.
Progressive rotator cuff and scapular rehab once acute pain settles — restoring strength and preventing compensation patterns.
Pain management — anti-inflammatories and, in severe acute flares, a physician-administered corticosteroid injection can help you sleep and participate in rehab.
When to consider referral
Deposits that don't respond to conservative care over 6-12 months, or extremely large deposits, may need imaging-guided procedures or, rarely, surgery.
Sudden severe shoulder pain deserves a proper assessment. Come in and let's figure out what's driving it and build a plan to get you comfortable again.