Calcium Deposits in the Shoulder

Here is an example of a calcium deposit in a 45 year old female with increasing right shoulder pain. See the image below for an arthroscopic view of this calcium deposit in the rotator cuff.

Calcium deposits around the shoulder are fairly common. They usually do not cause problems, but if they increase in size or become inflamed, they can be very painful. 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.

Why do calcium deposits form around the shoulder?

Most calcium deposits have no known cause. People often believe the deposits occur from too much calcium in their diet, so they ask if they should reduce their calcium intake. This should never be used as a from of treatment, since a normal balanced diet with a calcium supplement of up to 1000mg a day is healthy; particularly for anyone past 55 years of age, and for post-menopausal women.

How are calcium deposits diagnosed?

Calcium deposits are usually diagnosed with a routine x-ray. In some patients, they are just an incidental finding and cause no pain or symptoms. However, if the calcium deposit becomes too large or starts to grow, it can cause severe pain as it starts to erode the rotator cuff.

Who usually develops calcium deposits?

Calcium deposits develop most frequently in women between 35 and 65 years of age, but they also develop in men.

Here is the arthroscopic view of the calcium deposit in the shoulder located in the rotator cuff, the most common location for it to occur. It can erode the rotator cuff and cause pain and destruction of the rotator cuff tendon.Many calcium deposits are present for years without causing pain. Only when they are large enough to be pinched between the bones when the shoulder is elevated do they cause pain. Smaller deposits may cause pain if they become inflamed, especially when the calcium salts leak from the deposit into the sensitive bursal tissues of the joint lining.

Will calcium deposit damage my shoulder?

Some calcium deposits can cause erosion by destroying a portion of the rotator cuff tendon. However most calcium deposits remain on the outside of the rotator cuff tendon the bursa (the structures that hold the the joint fluid) and only cause problems because of the pain caused when they catch during shoulder movement.

Is the calcium deposit hard like a rock?

In the early part of formation, most calcium deposits are very soft like toothpaste, but when they have been present for a long period of time, they dry and become chalk-like, sometimes even turning to bone.

Here is an example of a calcium deposit which is in its early stages and is very soft.

The tip of the needle points to the calcium deposit.

CLICK HERE TO SEE A VIDEO CLIP OF WHAT IT LOOKS LIKE AT THE TIME OF ARTHROSCOPIC SURGERY

What is the best treatment for a calcium deposit depends on what sort of symptoms it is causing. When the calcium deposit becomes inflamed, either because it ruptures and leaks calcium salts into the bursa, or because it pinches the bursa or rotator cuff, the pain can be quite severe. The acute inflammation can be treated with ice packs over the area and rest in a sling, but oral anti-inflammatory medications are also helpful. A cortisone injection directly into the area of the calcium deposit may provide relief with a few hours, but without it, severe pain may last for several days.

Should calcium deposits be removed?

If someone has two or three episodes of recurrent pain and inflammation in the shoulder, or if the calcium deposit appears on x ray to be enlarging, then arthroscopic surgery to remove it should be considered.

Stages of calcium deposit in shoulder

The tip of the needle points to the calcium deposit.

What is involved in arthroscopic surgery to remove calcium deposits?

The procedure is done as outpatient surgery under general anesthesia. The operation is painless, and only a mild aching sensation is felt for a few days after the operation while the skin puncture sites heal. If the calcium has eroded in a hole in the rotator cuff, then it is necessary to remove a portion of the overhanging bone which will cause a little more discomfort for a few days.

CLICK HERE TO SEE A VIDEO CLIP OF A HARD CALCIUM DEPOSIT OF THE SHOULDER

CLICK HERE TO SEE THE SECOND VIDEO CLIP OF A HARD CALCIUM DEPOSIT OF THE SHOULDER

Here is an x-ray taken after the arthroscopic surgical procedure. The calcium deposit has been removed and the rotator cuff has been repaired. There will sometimes be some small spots of calcium that are left and seen on the x-ray which will cause no further problems. The most important thing is to decompress the calcium deposit to keep it from eroding the rotator cuff tendon.

Will calcification return once the deposits have been removed?

We have never seen calcification return in the same shoulder.

Will calcification cause any permanent damage?

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

To see more information about the shoulder, including video animations of shoulder anatomy and other shoulder injuries and ways to treat them, please click here.

View Our Office Video