Limescale shoulder

Calcium is a common cause of shoulder pain, and women between the ages of 30 and 50 are particularly affected.

How does the calcium get into the shoulder?

Calcific tendonitis (calcific tendinosis) is a condition affecting the rotator cuff. Calcification particularly commonly affects the supraspinatus tendon.

But why does lime come there of all places?

The cause is reduced blood flow to the rotator cuff, which leads to calcium deposits in the supraspinatus tendon.

Due to its course, the supraspinatus tendon is particularly frequently exposed to shear and compressive loads under the acromion.

As a result, calcium can build up in the tendon insertion during remodeling processes, which can cause shoulder pain.

This is the spontaneous course of a calcified shoulder.

The course of a calcified shoulder is usually divided into 4 phases.

• In the first phase, cell transformation, the tendon tissue is converted into fibrocartilage. The patient usually feels no or only very mild pain.

• In the second phase, calcification, the cartilage partially dies and is replaced by calcium deposits. From this point on, the condition can be easily diagnosed using ultrasound and, later, X-rays; magnetic resonance imaging is less sensitive during this phase. If the shoulder tendon becomes severely stretched by the calcium deposit, tightness in the acromion can occur when raising the arm. This impingement, known as impingement, irritates the tendons that glide beneath the acromion, especially the supraspinatus tendon and the bursae.

• In the third phase, the resorption phase, as the name suggests, the calcification is reabsorbed (dissolved), which is accompanied by sometimes severe inflammatory reactions. This can trigger severe shoulder pain. If individual calcifications extend into the bursa of the acromion (subacromial bursa), they can cause bursitis.

• The fourth phase is the repair stage: As the calcium deposit dissolves, the symptoms decrease. Not every calcific tendon completes all cycles; it can remain in any stage. The symptoms of a patient with calcific tendon can vary. This depends primarily on the size of the calcium deposit and the stage of the disease.