Tendinosis calcarea is the medical term for tendon calcification. This is most commonly seen in the shoulder.
What is tendinosis calcarea?
There is talk of tendinosis calcarea when there is calcification of different tendons. It is caused by the deposit of calcium crystals. In principle, tendinosis calcarea can occur in any body tendon, but in most cases it shows up in the shoulder tendons as well as in the supraspinatus tendon of the supraspinatus muscle. Doctors then speak of a calcified shoulder. For what does hypesthesia stand for, please visit ezhoushan.net.
Occasionally, however, tendinosis calcarea also develops in the patellar tendon of the knee or in the Achilles tendon. Occasionally, the rotator cuff is also affected by tendon calcification. In most cases, tendinosis calcarea occurs between the ages of 40 and 50. Women are slightly more likely to suffer from tendon calcification than men. It is estimated that tendinosis calcarea occurs in two to three out of every hundred people.
It is not yet known how tendinosis calcarea develops. Degenerative tendon changes are suspected. The pressure on the affected tendons is increased by signs of wear and tear, for which the natural aging process and weaker blood circulation are responsible. As a result, calcium crystals are increasingly stored in the tissue, which leads to painful symptoms when performing movements.
The crystals cause the tendon to thicken in the shoulder joint, which means that when the affected arm is lifted it is pinched between the acromion and the shoulder joint, which in turn causes pain. As the tendinosis calcarea progresses, the body’s defense system sends out macrophages. These are special immune cells that are supposed to break down the crystals. This causes the tissue to scar and the tendon to continue to thicken.
Symptoms, Ailments & Signs
The symptoms associated with tendinosis calcarea depend on which tendon it occurs on. If the calcification shows up on the shoulder, there is pain when lifting the arm. The same applies if the person concerned lies on their side.
In some cases, arm movement is no longer possible at all, which is referred to as pseudoparalysis. The longer the tendinosis calcarea lasts, the more the symptoms worsen. As the disease progresses, there is a risk of the tendon calcification transferring to the shoulder joint. The result is inflammation of the bursae, which is accompanied by severe pain.
There is also redness and an overheated joint. Pain-free movements can usually only be carried out when the arm is spread apart and rotated outwards or inwards. Secondary symptoms can also occur as a result of calcific tendinosis, such as neck tension or headaches.
Pain-avoiding cumbersome movements often lead to tense neck muscles. Sometimes the pain in the neck is so intense that the tendinosis calcarea is no longer registered. In some people, however, tendon calcification causes no symptoms at all, so their diagnosis is purely coincidental.
Diagnosis & course of disease
If there is a suspicion of tendinosis calcarea, the patient should contact an orthopedist who specializes in complaints of this type. The proof of tendon calcification is usually already possible by means of a sonography (ultrasound examination). In this way, the limescale causes noise to be extinguished, which can be determined as part of the investigation.
In addition, the precise position of the calcium deposit can be determined with sonography. This makes it easier for the doctor to track down the limescale, which has a positive effect on the planning of a surgical intervention. With tendinosis calcarea, the thickening is always in the middle of the tendon.
Another diagnostic method is an X-ray examination. The tendon calcifications are usually clearly visible on the x-rays. In order to precisely determine the focus of limescale, however, recordings from several angles are required. The course of tendinosis calcarea varies from person to person. There is a chance that the pain will increase rapidly.
However, they can also fail slightly for a longer period of time. It is not uncommon for painful inflammation to occur due to calcium deposits, which, however, break down the calcium. In some patients, the tendon calcification regresses on its own due to the body’s self-healing process, while others require surgery.
Tendinosis calcarea can cause different complications, depending on which tendon it shows up in. If the calcification occurs on the shoulder, there is pain when the arm moves. In severe cases, the arm can no longer be moved at all. This pseudoparalysis worsens as the disease progresses and can eventually lead to complete tendon calcification in the shoulder joint.
A possible consequence of this is inflammation of the bursa, which is always associated with severe pain and the risk of further infections. In addition, redness and overheating occur in the affected joint. In individual cases, those affected suffer from headaches and tension in the shoulder and neck area. The treatment of tendinosis calcarea also involves risks. Side effects and interactions occasionally occur after taking pain-relieving medication.
Patients who are already suffering from a disease of the cardiovascular system or the immune system are particularly susceptible to acute symptoms and long-term effects. Typical complications are, for example, gastrointestinal complaints, headaches, muscle and body aches, skin irritations and muscle weakness. In the long term, it can damage the heart, kidneys and liver. The usual complications are conceivable during a surgical intervention: bleeding, nerve injuries, infections and wound healing disorders.
When should you go to the doctor?
In the case of tendinosis calcarea, medical treatment should always be carried out. It can also not come to an independent healing, so that the affected person is always dependent on treatment by a doctor. If the tendinosis calcarea is not treated, further complications arise and the symptoms worsen. For this reason, a doctor should be contacted as soon as the first symptoms of the disease appear. The doctor should be consulted if the person concerned suffers from severe pain in the arm. These appear for no particular reason and will not go away on their own. They can also appear in the form of rest pain and have a very negative impact on the sufferer’s quality of life.
Reddening of the affected area is also often an indication of tendinosis calcarea and must be checked by a doctor. The disease can also show up as severe pain in the head or neck. If the symptoms of tendinosis calcarea occur, either an orthopedist or a general practitioner can be contacted.
Treatment & Therapy
Tendinosis calcarea can be treated both conservatively and surgically. As part of the conservative treatment, the patient receives painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs). Sporting activities or gymnastic exercises should be avoided because they make the pain worse.
The orthopaedist also has the option of injecting local painkillers directly into the affected body region. Shock wave treatment is a therapy option for a calcified shoulder. With this procedure, a short, intensive pressure pulse is delivered, which leads to better blood circulation in the tissue. In addition, new blood vessels form and the calcium deposit dissolves. As the tension pressure decreases, the pain decreases.
If the symptoms persist despite conservative treatment, an operation must be performed, which is rarely the case due to the high rate of spontaneous healing. The surgeon removes the calcium deposits and expands the subacromial space. The procedure usually takes place through a minimally invasive arthroscopy. After the operation, the patient has to take it easy for about three weeks.
To prevent calcific tendinosis, doctors recommend a magnesium-rich diet. Magnesium-rich foods include nuts and whole grain products.
If the tendinosis calcarea has to be treated surgically, subsequent aftercare is extremely important. After the surgical procedure, the affected shoulder should be rested for about three weeks. To treat the pain, the patient is given medication that has an analgesic and anti-inflammatory effect.
An important part of the aftercare of a calcified shoulder is the subsequent physiotherapeutic exercises. They take place after the acute pain subsides. After the tendon has healed, a pain-adapted mobilization treatment is carried out. If passive exercises are carried out in the first phase of therapy, active exercises are carried out in the second phase, which are useful for achieving full freedom of movement of the shoulder joint.
Pain-adapted therapy is understood to mean exercises that only load the shoulder as much as the pain allows. The pain threshold must not be exceeded. The postoperative follow-up treatment also includes a third phase. Within this framework, the stability, strength and muscle coordination of the affected shoulder can be completely restored.
Normally, the pain after a calcified shoulder operation has subsided noticeably after 24 to 48 hours. Therefore, the further follow-up treatment, which is carried out on an outpatient basis, can usually be carried out without any difficulties. The general state of health and any previous illnesses of the patient are also important. In about 90 percent of patients, long-term satisfaction can be achieved through follow-up care.
You can do that yourself
Patients with tendinosis calcarea primarily suffer from recurring pain, which increases in frequency and severity as the disease progresses. However, those affected must be aware that tendinosis calcarea cannot be treated solely through self-help measures. Relief of symptoms through self-help measures is usually only temporary. Because if there is no medical intervention and therapy, the tendinosis calcarea progresses increasingly, which intensifies the pain.
In general, physiotherapeutic measures are considered a good way to reduce some of the symptoms caused by tendinosis calcarea and to promote muscles and mobility.
However, if these conservative therapy methods do not show the desired success, the patients usually have to undergo an operation. Here, too, those affected have the opportunity to positively influence the outcome of the surgical intervention through active participation. Sport should be avoided before and especially after the procedure. After the operation, patients with tendinosis calcarea also strictly adhere to the medical instructions regarding physical rest. With targeted scar care, those affected can help ensure that the surgical scars heal as well as possible and that no infections develop. The patients only practice sports again after medical permission.