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ConditionShoulder & arm

Calcific Shoulder Tendinitis

Calcific shoulder tendinitis treatment in Amsterdam. Your physiotherapist helps with exercise therapy, advice and, where it fits, shockwave therapy.

Calcific Shoulder Tendinitis

What is it?

With calcific tendinitis, calcium sits in one of the tendons of your rotator cuff, the muscles that keep your upper arm centred in the socket. It usually involves the supraspinatus tendon, on top of your shoulder. You feel the pain around the top of your shoulder and upper arm, and raising your arm hurts most.

The calcium goes through phases. While it builds up and then rests, you often have little pain. The worst pain comes when your body clears the calcium, through an inflammatory reaction around the deposit.

Some people have calcium in the shoulder without any symptoms. Calcific tendinitis differs from frozen shoulder, where the joint capsule stiffens. For general information on shoulder pain, see our shoulder complaints page.

Common causes

  • A disrupted healing process in the tendon (the exact cause is unknown)
  • Middle age

How we diagnose

Your physiotherapist asks how your symptoms started and examines your shoulder, shoulder blade and neck. That way we tell calcific tendinitis apart from frozen shoulder, osteoarthritis or pain referred from your neck.

Only imaging shows calcium. With ultrasound your physiotherapist can sometimes see a deposit, as a supplement to the examination. If symptoms persist after three months of treatment, your GP requests an ultrasound or X-ray.

Treatment approach

During a severe pain flare, you discuss pain relief with your GP, who may also consider an injection. Your physiotherapist helps you keep moving within the pain. After that you build strength and control in your rotator cuff and shoulder blade step by step, at home and in our gym.

If an ultrasound shows calcium and exercise, pain relief or an injection have helped too little after about three months, your physiotherapist can add shockwave. That happens in your regular appointment, with no surcharge.

Expected recovery

Calcific tendinitis often resolves on its own: your body clears the calcium and the pain goes away. That can take longer than a year, and some people keep having symptoms.

Your physiotherapist keeps your shoulder strong and mobile during that time, and reviews with you whether a next step is needed.

Frequently asked questions

Does calcific shoulder tendinitis go away on its own?
Often it does: your body clears the calcium itself and then the pain goes away. That can take longer than a year, and some people keep having symptoms. Exercise therapy and good pain relief help you through that period.
How do I know if I have calcium in my shoulder?
Only imaging shows calcium. With ultrasound your physiotherapist can sometimes see a deposit, as a supplement to the examination. If symptoms persist after three months of treatment, your GP requests an ultrasound or X-ray.
Does shockwave therapy help with calcific shoulder tendinitis?
Studies show mixed results, and the quality of the evidence is low to very low. The Dutch GP guideline lists shockwave as an option when exercise, pain relief or an injection help too little. Your physiotherapist assesses your shoulder first, can start in the same appointment and sets the intensity with you, because shockwave can be painful.
What is barbotage for calcific tendinitis?
In barbotage, a radiologist or orthopaedic surgeon needles the calcium under ultrasound guidance, rinses it out and leaves a corticosteroid behind. Your GP refers you when injections and exercise therapy have helped too little, and Physical Studio does not perform it. The evidence is uncertain: in one trial, barbotage did no better than a sham procedure after two years.
Can I exercise with calcific shoulder tendinitis?
That depends on your pain. During a severe flare, you keep the load light and avoid overhead movements that make the pain worse. After that, you rebuild strength and overhead movements step by step, with your physiotherapist and in our gym.
Do I need a referral, and is treatment covered?
You do not need a referral for physiotherapy. Imaging, an injection or barbotage go through your GP. Physiotherapy usually falls under supplementary insurance, and shockwave costs nothing extra with us.

Related conditions

All conditions

Related treatment

Shockwave therapy

At Physical Studio in Amsterdam, your physiotherapist uses shockwave for tendon pain that has lasted three months or more and has not improved enough with exercise therapy. You book a regular appointment and pay no surcharge.

Your first appointment

Intake Physiotherapy

covered by supplementary insurance

Does this complaint sound familiar? Start with an intake. You get a clear diagnosis and a treatment plan in the same appointment.

  • Full physical examination by a physiotherapist
  • Ultrasound diagnostics where needed
  • Diagnosis and treatment plan in the same appointment
  • Book online right away, no referral needed
Book your intake
Ultrasound diagnostics in a Physical Studio treatment room