How to Identify and Cure Limestone Tendonitis

Calcareous tendonitis occurs when there is a deposition of small calcium crystals in a tendon. This calcification can disappear on its own, without the need for treatment, but when this does not happen, ultrasound in physical therapy can eliminate calcium deposits, with no need for surgery in most cases.

It is not yet known exactly why this calcification forms, but the most accepted theory is that it forms due to the decrease in blood that reaches the inflamed tendon, with a deposition of calcium salts there. Changes in the thyroid and estrogen metabolism may also favor its formation.

It usually forms after the age of 40 and is more common in women, and although it can appear on only one side of the body, it can also affect both at the same time. One of the most affected tendons is the supraspinatus tendon, as shown in the image above, but the rotator cuff of the shoulder is also very affected.

How to identify a calcification in the tendon

The only way to be able to identify a calcification in a tendon is through imaging tests. The X-ray must not show the tendon, however, in case of calcification, a small whitish area can be seen in the place where it formed.

When palpating the tendon, the person should feel some pain, but it is not possible to say that there is calcification only due to pain and therefore an image exam can be useful, although it is not usually requested just because of this suspicion.

How to treat calcified tendonitis

Often, calcareous tendonitis cures on its own because there is a spontaneous remission of bone deposition, however, it is not known when this happens and therefore whenever the person has symptoms, he or she should undergo treatment with a few physiotherapy sessions, often using the electrotherapy, to reduce inflammation and pain of surrounding tissues. Ultrasound is also capable of reducing calcification, with excellent results.

Painkillers and anti-inflammatories in pills or ointments can also help fight pain but in the most difficult cases, when no treatment brings symptom relief, arthroscopy surgery may be indicated. This surgery consists of scraping the calcified site, completely eliminating the calcification. Infiltrations with anesthetics and corticosteroids are also indicated to immediately relieve pain, but they can only be performed 1 to 2 times a year.

Here are some quick tricks to combat pain in the following video:

Physiotherapy for calcified tendinitis

In physiotherapy, TENS and ultrasound are indicated for pain control although it is not yet known exactly how ultrasound acts on the reabsorption of deposited calcium, it increases the temperature of the site and blood flow, facilitating the removal of calcium deposits.

Exercises such as stretching and muscle strengthening with elastic bands such as Theraband are indicated as well as joint manipulation techniques. Pendulum exercises are excellent strategies to reduce pain and maintain the integrity of the capsule by preventing the shoulder protection position, which generates more pain and restricts movement.

Resting of the affected limb is indicated when there is pain and limited movement and, therefore, whenever possible, avoid holding heavy objects with the affected arm. However, absolute rest is not necessary and, therefore, the use of a sling is not recommended because it is important to maintain some movement to maintain the production of synovial fluid that irrigates the joint.