Calcium deposits around the shoulder are a fairly common occurrence. Often they do not cause problems, but if they increase the in size or become inflamed, then very severe pain may result. This collection of questions and answers is intended to explain this common shoulder problem and describe the methods we recommend for treatment in different situations.

What causes calcium deposits around the shoulder?

In most situations, there is no known cause for calcium deposits. Many people ask if their diet should be changed to reduce calcium intake. This should never be used as a form of treatment, since a normal balanced diet with a calcium supplement up to 1000 mg a day is healthy in a normal patient, particularly senior citizens and post-menopausal females.

Who is most commonly gets calcium deposits?

Calcium deposits occur most frequently in females between the ages of 35 and 65, but may occur in males as well.

Do all calcium deposits cause pain?

Many calcium deposits are present for years without causing any symptoms. Only when the deposit becomes large enough to pinch between the bones when the shoulder is elevated, does it cause pain. Sometimes smaller deposits cause pain if they become acutely inflamed, especially when the calcium salts leak from the lesion into the sensitive bursar tissues.

Does a calcium deposit damage my shoulder?

Some calcium deposits can cause erosion with the destruction of a portion of the rotator cuff tendon. Most calcium deposits do not significantly injure the rotator cuff tendon and only cause problems because of their pain and catching.

Is the calcium deposit hard like a rock?

Most early calcium deposits are very soft like toothpaste, but sometimes after being present for a long time, they do dry up and become chalk like, sometimes even turning into bone.

What is the best treatment for a calcium deposit?

When a calcium deposit becomes acutely inflamed, either because it ruptures and leaks calcium salts into the bursar, or because it pinches the bursar or rotator cuff, the symptoms can be quite severe. The acute inflammation can be treated with local ice packs and rest in a sling, but oral anti-inflammatory medications are also helpful. A cortisone injections directly into the area of the calcium deposit may give relief within a few hours, when without it the acute pain may last several days.

Do calcium deposits need removal?

If a patient has two or three recurrent episodes of painful symptoms in the shoulder, or if the calcium deposit appears to be enlarging, then it may be appropriate to consider arthroscopic surgery to remove it.

What is involved in arthroscopic surgery to remove calcium?

The surgery is done under a general anesthetic and patients are able to go home the same day as their operation. After surgery, a mild aching sensations is usually present for a few days until the skin puncture sites heal. If the calcium erodes a hole in the rotator cuff tendon, then a decompression is necessary (removing a portion of the overhanging bone arthroscopically) and this will cause a little more discomfort for a few days. If the calcium deposit has eroded a portion of the rotator cuff tendon then it may be necessary to repair the tendon with suture alone or with a screw in suture anchor. This is also done arthroscopically All arthroscopic surgery is videotaped for the medical record and for patient education. Patients are encouraged to look at their videotapes so that they can better understand their surgery.

Will calcification return once it is removed?

I have never seen a calcification return in the same shoulder once it has been removed.

Can there be any permanent damage caused by calcification?

Yes. A long term calcification may cause pressure on the rotator cuff tendon which can damage portions of the tendon permanently.

Who can I call for more information?

Please feel free to contact us and ask one of our physicians for a referral. We will be happy to answer your questions and evaluate your shoulder in the Clinic.

Don Buford, M.D. © 2008