Calcific Tendonitis of the shoulder - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the condition of calcific tendonitis.
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Calcific Tendonitis of the shoulder - Everything You Need To Know - Dr. Nabil Ebraheim
• Calcific Tendonitis of...
Calcific tendinitis of the shoulder
Calcific tendinitis is calcium deposits in the supraspinatus tendon. It is a condition that usually occurs in adults around the fourth decade of life and there is a higher incidence in diabetic patients. Calcific deposits cause severe pain in the shoulder and that pain is increased by elevation of the arm above the shoulder and it also leads to decreased range of motion of the shoulder. It is actually deposited calcium carbonate apatite crystals into the rotator cuff tendon. This condition is more common in females and the clinical symptoms and presentation is similar to impingement syndrome of the shoulder. Some of the patients will have diabetes or hypothyroidism. There is no history of trauma and the etiology is clearly not known. The calcific tendinitis has many phases and the most painful time is during the reabsorptive phase. These deposits affect the function of the rotator cuff causing chemical irritation and shoulder impingement. It reduces the space between the rotator cuff and the acromion and that will lead to shoulder impingement. X-rays are the gold standard for the diagnosis. The x-ray will show calcium deposits about 1 to 2 cm from the supraspinatus insertion (this is the tendon most commonly affected). The appearance of the lesion on x-ray varies from a fluffy, cloudy appearance with a poorly defined periphery and the patient will have more pain in this type than the other type, which is a well-circumscribed, dense calcification. The MRI may be difficult to interpret, however we can see a small, black signal in the supraspinatus of the MRI. There will be a low signal intensity in all sequences. The MRI is not necessary for the diagnosis. The x-ray is more helpful, however we get the MRI to see any associated pathology such as a rotator cuff tear.
Treatment
Conservative
• Physiotherapy (for stretching and strengthening the rotator cuff)
• Anti-inflammatory medication
• Subacromial injection
o Conservative treatment results in improving the symptoms and about 60 to 70% of patients after 6 months.
Surgery
• Involves removal of the lesion and possible repair of the rotator cuff tendon.
• Done in larger lesions are when conservative treatment fails.

[@Lyclah]

If anyone is reading this, I want to share my experience during my first week after finding out I have calcific tendinitis. Until the 5th day, there was no improvement in the pain and rotation, but after that night, the pain started to fade away. It's not entirely gone, but there has been a visible improvement day by day. I can now move my shoulder at different angles more freely. For example, I couldn't wash my hands until the 5th day because rotating my hand caused me to scream in pain. Today, I can raise my arm a little higher than head height towards the front. I also stopped taking painkillers yesterday (6th day). Anyways, I spoke to one of my physiotherapist friends, and they advised me to do some very minimal movements to increase blood flow to the shoulder. This helps the shoulder absorb the calcium pocket more quickly. These movements are very small, and if anyone wants to know more, I can describe them in more detail later. Additionally, I started taking a multivitamin that contains a significant amount of Manganese, which helps the body absorb calcium faster. I can't say for sure if the physiotherapist's movements or the supplements helped, but if they made any minimal improvements, I am grateful. On the 6th night, I was able to sleep on my chest with my arms on my side. When sleeping on my back, I'm using a folded sports bottom to support my shoulder and arm. A friend suggested using a memory foam, which would be a better option. But if you don't have access to a memory foam, try experimenting with different items from your wardrobe to find a position that allows your arm to rest comfortably. During the first 3 days, I slept on the couch in an almost sitting position while crying. There wasn't any position in bed that would allow me to close my eyes. Anyways, if I hadn't read the comments from the beautiful people here and received their help, I would have been stuck in a very bad mindset. Thank you all, guys! These are my thoughts about the first week. I hope anyone who has this illness gets better and returns to normal life quickly. Cheers, everyone!

[@elainepetras236]

Was it manganese or magnesium

[@Lyclah]

@@elainepetras236 didn't see any doctor afterwards. I was waiting my health insurance to start. Possibly I'll go and be checked in 2-3 weeks. Also I didn’t notice any disturbances for months. It’s like a regular shoulder.

[@pauld.436]

Thank you for your post

[@mariapinto9886]

U must not b diabetic I'm diabetic n snr citizen n hv frozen shoulders since more than 4 mths ive been to 4 physiotherapists taken tense, ultrasound now I'm taking heat n doing some exercises my range of motion has improved it takes long time to heal I eat healthy

[@NettaGodsMessenger]

I’m dealing with this at present. I’m in severe pain myself. Can only take Ibuprofen and I’ve taken muscle relaxers. I’ve run out of muscle relaxers! I’ve been to emergency room! Can’t lift my arm up. In a lot of pain if I try to and I mean this is so painful! I haven’t been able to sleep well at night either! I’ve been praying and crying and asking other people to pray for me but I’m still going through! This mess hurts so bad! I’m hoping that this goes away on its own soon. Thanks for sharing! It gives me a hope that I will get better soon!

[@MG-gb5ql]

I was just diagnosed with this and it’s been 6 days from when the pain started. Wearing a sling, taking ibuprofen, magnesium citrate, resting as much as possible is helping. I was sleeping on a couch almost in a sitting position, i can now sleep on my bed with a pillow on my side to sit my arm on which helps minimize the pain. Pain has subsided for me even though i know my recovery is slow but i’m hopeful. Just putting this out there for anybody who is dealing with this.

[@ShinySilverBunny]

Use topical magnesium oil or lotion. This will help over time to break up calcium deposits. Skin absorbed magnesium is highly effective just like sea water

[@lilfishbigsea007]

My wife is dealing with this exact same thing that just started for her. Thank you for your post. How are you feeling and did the pain go away for you?

[@mindfullife581]

@@lilfishbigsea007 The pain did go away after a few more days of me writing the comment. I purchased a shoulder brace on amazon and that helped me a lot. I had lost mobility on my arm and couldn't lift it up and gradually every day I could reach a little higher until it was back to normal. I also bought a memory foam pillow which helped take pressure off my shoulder and has helped with keeping pain from coming back. I was diagnosed with arthritis on my shoulder afterwards and was prescribed meloxicam.

[@Lyclah]

It is my 5th day on pain and can't describe how much hope your comment gave me. I'm totally devastated. Thank you so much sir! Hope you’re okay by now and never have this illness again. Cheers!

[@MG-gb5ql]

@@Lyclah hang in there! I know it’s awful but i was back to normal by the second week. The memory foam pillow was a lot of help. I was told if needed i could go in for a steroid injection. Which i didn’t need but it’s an option if you don’t see it improving.

[@user-yk5op4cx6c]

Thank you all,I've been dealing with pain in shoulder,for three days, know I've got good idea what I'm dealing with , turning 70 in few mo.s , wow getting old sucks .

[@dustinshorter6544]

Wow, these comments are tremendously helpful. Dealing with this myself on day 5 now.

[@Noone73902]

If you’re in the worst pain and crying and wondering if this will ever end, I’ve been there. I had pain and frozen shoulder issues for years, but a year ago the pain began to intensify. I went to the doctor and without any exam I was sent directly to physical therapy. I spent months in pain doing the PT before a more experienced physical therapist told me to get an MRI. There I found I had bilateral calcific tendonitis, big masses in both shoulders. I read in an old Chinese medicine book that homogenized milk caused it so I decided to quit dairy. I also read that dehydration can cause it, so I drank 60oz of wanted per day. To lower inflammation, I took Motrin around the clock and it helped a little. I still woke from pain every 2 hours. Ice packs helped. I went to an orthopedic doctor and got an ultrasound-guided cortisone shot in each shoulder (my PT advised me to request the ultrasound). I had relief from the intensity of the pain and gained some mobility quickly. Then after a few weeks I had sever pain again in one shoulder and my orthopedic doctor recommended that I have surgery to remove it because the masses were so large. I did another round of shots while I waited for surgery. I scheduled surgery, I prayed that I wouldn’t need it. I went back for an x-ray and after 2-3 months, the calcific deposited were almost all gone. My doctor was amazed. After the 3rd shot within 4 months, one shoulder is back to normal and the other is not too far behind. There is nothing but a dusting left of calcium, the other is clear. I hope this helps you in your journey, don’t give up hope.

[@westsidekasper4860]

Did your shoulders make weird squishy sounds when moving them or using grip strength?

[@mhnd491]

Did you do some specific shoulder exercises or stretches ? i am glad that every thing went well eventfully !

[@anassyria5176]

@@Noone73902 Thanks for sharing!

[@adelshukralla598]

hello McTelly My doctor advised me to undergo surgery to remove the calcification deposit on my right shoulder . I do not want to go for surgery. Could you please advise me

[@anassyria5176]

@@adelshukralla598 Sorry I know the question was not to me, but from my experience, surgery should be a last resort until all other less invasive options are exhausted with no success. Of course one should take into consideration age, physical condition and severity of the case to prioritize what treatment is adequate.

[@anassyria5176]

Workout is essential in my experience! I had the shoulder pain increasing since 2020, then it got worse in 2021, until one day it got so unbearable I woke up in the middle of the night crying from the pain. Next day I had an xray and was diagnosed with this. A significant calcification is clearly visible. I was prescribed by the doctor to have 7 sessions of shock-wave therapy and was told not to have high hopes due to the severity of the calcification and may need injections. However, when I went to the physiotherapist to start the shock-wave therapy, he saw that the shoulder range of motion is not that bad, and hence adviced me of doing moderate, careful workout, to strengthens the muscles supporting the shoulder before trying the shock-wave therapy. And for my surprise the very first day of workout I was able to sleep without the severe pain I had the night before! The workout strategy should be little or no weight and high number of repetitions with movements that don't induce significant pain (a very slight pain is ok if the movement is correct).

[@davidyummus6259]

I was wondering about this,... Maybe build & increase muscle around the shoulder to separate or open the joint ?

[@anassyria5176]

@@davidyummus6259 Exaclty. Both the size and strength of the rotator cuff muscles seem to be essential. Viweing the xray, the physiotherapist right away diganosed muscular dystrophy in the affected shoulder and said it's majorly contributing to the problem. I'm 32 and play sports moderately but due to the pain, I used my shoulder less and less resulting in the aggravation of the weakening and pain.

[@garrettcal1812]

Thank you.

[@dorlacastro1336]

I have been diagnosed with this for the past ten months and this is no play. I got the physical therapy and the injection. I am still in terrible pain. I wish I could take my arms off myself and remove the deposit, I will probably need surgery as the pain is unbearable.

[@brendabanks6000]

I hope you're pain had decreased, I was also diagnosed w calcific rotator cuff tendinopathy, 3 weeks ago. The pain was excruciating, the pain lasted 2 weeks, I did 15 min heat, 15 min ice treatment, took ibuprofen, apple cider 2x day, and took magnesium pills, I kept my shoulder in a sling. These, put a stop in my life. I couldn't raise my arm, get dressed, do my hair ect, I'm right handed. Well the orthopedic game me the kanalog shot and he did say surgery. I had no pain for 1 week. Last night the inflammation started again. So I believe that the removal of these calcium (surgery) may take place, bec w that rock on top of that tendon, the inflammation and pain will return. Just wanted to share this w you. I hope for you're soon recovery.

[@westsidekasper4860]

Hows it going? Did u hear squishy sounds in shoulder when moving arms

[@brendabanks6000]

@@westsidekasper4860 oh no squishy sound. But no more pain at all, I got the steroid injection and I've been able to move my shoulder, but now I have pain in my neck, figures right? So I just lay on a pack of ice before bedtime, if it's not one is the other. I hope you been feeling better my dear, thank you for checking up on me, I'll keep you posted on anything, hopefully that shoulder pain will not return, that was the most painful thing I had to endure specifically bec there's no pain medication for that.

[@westsidekasper4860]

@@brendabanks6000 yes i been shot n hit by 4 bullets and that wasnt as bad as this horrible neck and disc issues nerve pain and shoulders i feel like my body wants to give put on me doctors just want insurance money they dont care about us.

[@brendabanks6000]

@@westsidekasper4860 I hear you, they wanted me to have surgery I said no way, I don't have 4 weeks to sit at home, bills got to be paid, so I just deal with the pain and pray that the shoulder pain doesn't return. The ortho Dr don't care, they just get paid. Figures right, how sad right.

[@marmari6638]

Thank you for explaining it ,I was just diagnosed with it. I needed this explanation.

[@michelleblake8482]

Best explanation I have found todate. Thanks so much for sharing

[@mottjr100]

This is the most painful thing I have ever experienced in my life. I'm a provider and when every description of the problem includes "severe pain" they are not exaggerating. This is my second round. The first round I took every leftover pain pill in the house and at my neighbors house, wrote down what I had taken for EMS if/ when my husband had to call 911.

[@antypanag1]

another possible (non invasive) way of treatment = shockwaves (radial or focus - focus is painless)

[@theluckyman74]

I found an interesting study using cimetidine for severe calcific Tendonitis in parathyroid patients and had amazing results at reversing the calcification and reduced pain. I also had parathyroid disease for 6 years and now dealing with serious pain pretty much everywhere, but especially my shoulders. There was another study showing that both Cimetidine and famotidine were both effective in reversing calcific Tendonitis. Unfortunately people with high blood pressure and diabetes had reduced effectiveness. I going to try it shortly. They were using 200 mg twice daily of the cimetidine for 3 months.

[@jaynasmith1994]

@theluckyman74 I know this is from 7 months ago, but I was just diagnosed with this. Do you have any idea what dose of Famotidine was used in the studies? I tried Googling and found the studies listed, but only found the dosage for the Cimetidine. Thank you for your original post, it is very helpful.

[@sharonmb8817]

You've explained what's been haunting me for past 2 months in a few min. Thank-you!!

[@abdelhafidgaouar3464]

Merci PROFESSEUR un grand respect

[@cayrick]

I think I have learned enough from your videos to hop into the operating theater with a scapal and sewing kit.

[@searaph]

Did not know that it is more common in people with hypothyroidism. I've had hypo for years and calcifications in the shoulder have never been mentioned as something that I'm at increased risk for

[@natasha83196]

I'm getting the tenjet procedure done next week. The pain is so bad I am having trouble concentrating at work and not sleeping at night. I tried PT and it didn't work. I'm praying this Tenjet is the silver bullet.

[@regenehuddleston7557]

Thnk you for ur videos I had shoulder injury 11/2020 yes had physical therapy, then m.r.i. I'm recovering well & my goals getting accomplished again

[@renandabomb]

Did You have to do surgery? Was just diagnosed this this week It says 2 cm big

[@daniela7892]

Very informative. Is there a similar video for calcific tendonitis of the hamstring? Thank you

[@Bee-Kind-Baker]

Thank you so much. Appreciate you taking time to explain these things.

[@ghaneemaha5037]

Thanks very much I needed this explanation GOD BLESS YOU 🙏🙏🙏🤲👏💐

[@ChrisJohnson-hk6es]

This was very helpful! Just had an Xray done last week and they saw calcification tendinitis around the rotator cuff. The pain? Not fun at all! It came on suddenly while I was working. Lifting heavy freight. They started me on physical therapy, but I am not feeling confident it will work.

[@juderogers4919]

Thank you this was very well done and has helped me alot.

[@HakobKazarian]

Best explanation I have found to date. Thanks so much|!

[@DawnYogaCare]

Very helpful 👌 Thank you

[@Ababy7]

In confused and worried….. people are saying 5-6 days… this is my 2nd month dealing w this pain and it’s not getting any better, it goes down to my hand and sometimes my other arm and hand. I don’t understand and the pain is awful, I can’t sleep or do anything. 😭😭

[@shantabrimmage3036]

I was just diagnosed with this a week ago and when I say this pain is no joke, it's no joke. I can sleep or anything. I pain is so unbearable. Reading these comments really put my mind at ease a little because I see I'm not alone. I will try the remedies in the comments to see if it helps. How can I function at work with this pain? Is this considered a disability?

[@twickersfc]

I am currently on day 6 of this. It really is very painful and I still haven’t had a proper nights sleep - which is exhausting - but during the day at least I am seeing some improvement since around day 5 with a sling, rest and regular painkillers (co-codamol and ibuprofen) along with basic exercises. Mine was diagnosed via X-ray and it was pretty clear to me I needed to visit hospital given the degree of pain and limited movement of my arm.

[@anitalaff]

Informative video! Thank you.

[@mrc1737]

Thank you for posting and sharing this info!

[@qiuqiu6081]

Thank you Sir 😊

[@shelleylopresti6999]

I waited about 6 weeks but finally went in for a shot in my shoulder. My pain went up into my neck and collar bone and down to almost my elbow. Hoping the shot helps but realistically……preparing for surgery.

[@YaksonKimsabu]

좋은 영상을 올려주셔서 감사합니다 인대가 염증 생기면 힘들죠 고맙습니다

[@thirsty4knowledge200]

Great presentation!!! Thanks

[@NuCreature8]

Any way to get rid of the calcification ?

[@ClausDK]

What are we talkning size wise to be talking surgery???

[@Angela-cd9bj]

Helpful thank you.

[@ВасилийКолесник-й2ы]

Очень хочется услышать перевод.

[@Adelbelaid11]

Thank you .merci

[@mickmc1498]

Very helpful. My shoulders have both maybe from sport in early days. Painful.. 🤣🤣 Not diabetic as had blood test. Q.1 Will tens machine break up.. Q2. Is ultra sound better?

[@tariqrehman7723]

Thanks for this video

[@ladydiaz6761]

Thanks a lot for your explanation

[@djoni1457]

Thank you. Very helpful!!!

[@rimjemli8054]

Thanks a lot.

[@VideoNash]

thanks

[@radeloncar2878]

Thank you!

[@blancaluna9826]

Thank you

[@mariapinto9886]

Tk u doc for this info can i take calcium tablets

[@ifroxtv6043]

How much cost every surgery for rotator cut?

[@theluckyman74]

I heard ultrasound can break it up

[@ccmkoho]

Any data to support piezo wave therapy to break up calcium deposits?

[@shaileshjaiswal9287]

Thank you sir

[@mr.eastcoastgrow6132]

The pain is unbearable its been 7 days its the worst pain ive ever had.

[@gregdavis19]

I developed shoulder tendinitis after having a total shoulder.

[@soniabaptistaamei6334]

Tomei vacina 5 meses fico doendo até hoje

[@MR-sx3od]

What about barbotage?

[@krakerkraker11]

metabolic alkalosis

[@betterbonesph]

😊

[@yeseniarodrigues2794]

Just left the hospital and got told I hav this and I’m scared thinking I’m going to die in my sleep 😓

[@theluckyman74]

Many studies have reported treatment effects of H2 receptor antagonists (H2RA) on calcific tendinitis (CT) of the shoulder. The purpose of this retrospective study is to compare the clinical outcome between the cimetidine and the famotidine of CT of the shoulder. We studied 72 patients with CT of the shoulder who were closed with H2RA (cimetidine or famotidine) and loxoprofen sodium from 2005. They were treated as follows, 41 with cimetidine and loxoprofen (group C) (14 males, 27 females, average age 54.3 years old) 17 with famotidine and loxoprofen (group F) (10 males, 7 females, average age 58.4 years old) and 14 with loxoprofen(group N) (8 males, 6 females, average age 60.2 years old). Shoulder joint pain was assessed by using visual analogue scale (VAS), and the site and size of calcium deposits were calculated by X-rays (frontal view and scapula Y). In addition, influences of the complicating diseases (diabetes mellitus and hypertension) were evaluated for treatment effects. Groups C and F improved their pain and decreased calcium deposit size more than group N (p

[@theluckyman74]

Try cimetidine 200 mg twice daily for 3 months. You should see improvement

[@noninoni454]

Cimetidine was banned on the market in 2011

[@theluckyman74]

@@noninoni454 You can still find it on Amazon and everywhere else. I think the original company stopped making them and other companies started making generics. In Canada you need a prescription because they say it can interact with several medications.

[@mimicro83]

👍

[@jaywinters2483]

WARNING! I had this surgery. Problem is doctros don't want to squat for patient pain control. My SCHMUCH Dr. prescribed 5 mg hydrocodon/325 tylenol. SQUAT! pain control. worst pain of my entire life. Tell the Schmuck DR that if he wants to do this surgery, he's got to give you a prescriptioons for 10mg hyrocodone/325 tylenol. Doctors don't give a shit if you suffer. (Remember, ObamaCare was written by trial lawyers when Dems controlled al both houses and Executive Branch. Dem's love trial lawywer$.). Tell your doctor the prescription for pain post OP has to be either 10 mg hyderocodone, or he's not getting the $ for the surgery and yoou're not doing it. THIS TYPE OF SURGERY HURTS TOO MUCH FOR SUCH A PUNY PAIN DOSAGE!

[@tricci508]

Thank you .. this was very helpful

[@garrettcal1812]

Thank you

[@gamaltaher9714]

Thanks