The Shoulder Snowstorm - Calcific Tendinitis

There’s just something about a snow globe. It seems to bring out the kid in most of us. Simply staring at one or picking it up and giving it a good old shake brings about a kind of joy that is simple yet so profound. Watching the little “snowflakes” float around in a haphazard manner before finally settling to the bottom of the glass is something mesmerizing.

That being said, the reality of it can be quite different. Being caught in an actual snowstorm in real life is not an experience for the faint hearted. I’ve had firsthand encounters myself, and it is not an experience enjoyed by any stretch of the imagination. So, what does this blizzard weather forecast have anything to do with the shoulder. Well, in reality nothing much, not unless u have a little something called calcific tendinitis. A little bit on what calcific tendinitis is first.

Calcific tendinitis of the shoulder is a common yet often misunderstood condition that can cause significant pain and discomfort. This condition is characterized by the formation of calcium deposits within the tendons of the rotator cuff, a group of muscles and tendons that provide stability and movement to the shoulder joint. The exact cause of calcific tendinitis remains unclear, but several factors are believed to contribute to its development. As we age, parts of our body undergo degeneration and the tendons in our shoulders can undergo wear and tear, which may make them more susceptible to calcification. Furthermore, repeated shoulder movements or injuries can trigger the formation of calcium deposits. Certain medical conditions like diabetes can increase the likelihood of developing calcific tendinitis. There may also be a hereditary component, as some individuals are more prone to tendon calcification.

This condition typically presents with shoulder pain which starts suddenly and can be intense, particularly at night. This pain can lead to the shoulder becoming stiff, making it difficult to perform everyday activities. In some cases, inflammation can cause noticeable swelling. Diagnosis usually involves a combination of clinical examination and imaging studies. X-rays are particularly useful as they can clearly show calcium deposits within the tendons. Ultrasound and MRI may also be used to assess the extent of tendon involvement and to rule out other conditions.

Treatment for calcific tendinitis aims to reduce pain, improve shoulder function, and dissolve the calcium deposits. Most of this conditions can be treated conservative with rest and activity modification which includes avoiding activities that exacerbate the pain. Anti-inflammatory medications can help reduce pain and inflammation. In addition to those, physical therapy has a role to play in alleviating pain, improving range of motion and strengthening the shoulder muscles.

If all of the above does not work, then there’s the final option of surgery. The aim of the procedure would be to remove these calcium deposits while also dealing with any other injuries or defects that maybe be present. The procedure is done arthroscopically. Meaning via a camera inserted through keyhole incisions of the skin.

So, this is the part where I liken a snow globe to the shoulder. The joint acts like a glass of the snow globe and there’s fluid within the joint too. These calcium deposits sit nestled within the tendon of the rotator cuff. In order to remove them, your surgeon will displace it and send them floating around the joint. Viewed through the arthroscope camera, it has uncanny similarities to how a snow globe would appear once shaken. These deposits are then cleaned up, and the cuff tissue is repaired if necessary.

Preventing calcific tendinitis involves maintaining good shoulder health. Regular exercise, proper ergonomics, and avoiding repetitive shoulder movements can help. For those with metabolic disorders, managing the underlying condition is crucial. The prognosis for calcific tendinitis is generally good, especially with early treatment. Most individuals experience significant relief with conservative measures, though some may require more invasive treatments. Should your condition not improve with conservative treatment, your friendly neighborhood surgeon will always be on hand to help you weather the snowstorm.