A sudden, severe, and disabling shoulder pain that seems to come out of nowhere, often in the middle of the night, can be the hallmark of calcific tendinitis. It is one of the most acutely painful shoulder conditions a patient can experience, and one that is highly treatable with the right specialist approach.
Dr. Kushalappa Subbiah provides specialist assessment and surgical management of calcific tendinitis in Bangalore for patients whose symptoms do not respond to conservative treatment.
What is Calcific Tendinitis?
Calcific tendinitis of the shoulder occurs when calcium deposits form within one or more of the rotator cuff tendons, most commonly the supraspinatus tendon. As these deposits grow or begin to reabsorb, they irritate the surrounding tissue and can cause intense inflammation and pain.
The condition is one of the leading causes of shoulder pain and affects roughly 3 to 7 percent of the general adult population, though not all cases are symptomatic. It is more prevalent in people between the ages of 30 and 60 and is slightly more common in women than men. Contrary to what many patients assume, it is not strongly associated with any particular sport or occupation, though it can certainly occur alongside shoulder overuse.
Types of Calcific Tendinitis
Causes
The exact mechanism behind calcific tendinitis is not fully understood, but it is thought to involve a transformation of tendon cells into cartilage-like cells under conditions of low oxygen tension, leading to calcium deposition. Risk factors include age between 40 and 60, female sex, thyroid disorders, and metabolic conditions. It is not purely an overuse injury and frequently occurs in individuals with no history of overhead activity.
- Sudden and severe shoulder pain, often with an acute onset and at times occurring at rest or during sleep
- Pain that is typically located at the outer side or top of the shoulder and may radiate down the upper arm
- Significant restriction of shoulder movement due to pain, particularly with any overhead or rotational movement
- Tenderness when the shoulder is palpated over the affected tendon
- In some patients, a milder chronic aching pain that has been present for weeks or months before an acute flare
Diagnosis
Diagnosis is confirmed through plain X-rays, which clearly demonstrate calcium deposits overlying the rotator cuff tendons. Ultrasound is an excellent tool for identifying the size and location of deposits and can guide interventional procedures. MRI is used when there is diagnostic uncertainty or when an associated rotator cuff tear needs to be excluded.
Treatment
Subacromial Decompression and Arthroscopic Calcium Removal
For patients with persistent or severe calcific tendinitis that has not responded to conservative management, Dr. Kushalappa performs arthroscopic removal of the calcium deposits combined with subacromial decompression. Using keyhole incisions and an arthroscope, the calcium deposit is located, needled, and removed from the tendon. The subacromial space is decompressed to reduce ongoing impingement. The procedure is minimally invasive and is performed as a day procedure under general anaesthesia. Recovery involves a sling for 1 to 2 weeks, with physiotherapy beginning promptly. Most patients experience significant pain relief within a few weeks of surgery, with full functional recovery expected within 3 months.
Why Choose Dr. Kushalappa Subbiah in Bangalore?
Dr. Kushalappa Subbiah completed a Fellowship in Shoulder Surgery at the Sydney Shoulder Research Institute, where he trained in advanced arthroscopic shoulder procedures including labral repair and reconstruction. He holds the International Olympic Committee (IOC) Diploma in Sports Medicine, and has direct clinical experience managing shoulder injuries in Indian athletes across cricket, swimming, tennis, and contact sports. He is appointed as a Consultant Shoulder Surgeon at NH Hospital, Bangalore.