What are Calcifications?
When calcifications are allowed to build up in the joints and tendons in the body, the painful inflammation can be treated by both traditional and alternative methods. When excess calcium deposits are able to build up in the body, they are known as calcifications. They can be found in a number of places, including the arteries, the breasts, kidneys, in the form of kidney stones, muscles, lymph nodes, and in the joints. Most causes of calcifications in soft tissues are due to damage from infection, injury, autoimmune disorders, loss of blood flow, aging, and tumors. These deposits are mostly benign, except for when they take the form of certain types of cancer or atherosclerosis (clogged arteries in heart disease). Calcifications in tendons and joints could cause pain and limited movement, due to the inflammation. The calcium crystals can also erode cartilage.
Calcium builds up in areas where there are damaged cells. Normal amounts of calcium consumption do not cause this buildup to occur. However, it is the overuse of supplements, such as vitamin D, which increase the absorption of calcium into the blood. It is this overuse which may cause high amounts of calcium in the blood (hypercalcemia). In time, this can lead to calcifications in the body.1
Synovial fluid and cartilage in the joints have calcium. This is normal, but when it crystallizes, those shards can damage the surface of the joint and allow enzymes to break the cartilage down. This is common in patients who are having knee surgery for osteoarthritis. The rotator cuff of the shoulder can also have calcifications. This is called calcific tendinitis. Injury or overuse of the shoulder may or may not be involved; however, it occurs when there is some cellular change or tissue damage. Inflammation causes pain and decreased range of motion. It becomes more difficult for patients to engage their shoulder in regular range-of-motion when the movements cause pain.2 Patients may complain of the shoulder snapping, catching, or being stiff and weak. Lying on the shoulder, or raising the arm high, can cause more pain.3
Typical treatments for calcific tendinitis include methods like the use of moist heat, the application of ice, professionally directed physical therapy, and the patient’s consumption of anti-inflammatory medications in order to begin to relieve the area. At times, surgery will be recommended to directly break up and remove the tendon deposits. Invasive surgery should generally be avoided unless it has been deemed officially necessary by a medical professional.4
There is controversy over whether or not calcium dietary restrictions should be imposed upon the patient when calcium buildups are present. This would include having the patient avoid milk, nuts, some vegetables, and calcium-fortified foods. Patients would be on this restricted diet for 3 months, to see if pain improves as a result of these dietary eliminations. Extracorporeal shockwave therapy, which uses directed soundwaves, has been found to have some success. Analgesics, NSAIDs, and corticosteroid injections have limited and temporary results. Surgery, while effective, has its own set of associated risks and side effects, and arthroscopic and open shoulder surgeries are considered to be difficult operations.5
Gentle exercises can be helpful for patients who suffer from the effects of acute calcification. Acupuncture can also be beneficial for some patients. There are natural anti-inflammatory substances that patients may try, such as fish oil, bromelain, quercetin, Omega 3 fatty acids, turmeric, glucosamine-chondroitin, ginger, and others. Avoidance of known allergens and processed foods, as well as eating a healthy diet, can all contribute to helping minimize the chance of calcification. Patients who are unsure of potential allergens might wish to be tested.6
Sometimes calcium deposits will resolve after a time period of 1-4 weeks on their own. When the calcium deposits are being absorbed (the acute phase), the patients experience pain. The calcific deposit at that point has a consistency to it which could be described as “toothpaste-like”. Safe treatment during the acute state of calcific tendinitis can come from chiropractors. Using a sling and icing would be recommended for home care, in-between visits to the professional.
Chiropractic care treatments for this particular condition should not include ART (Active Release Technique), the Graston Technique, or friction massage if the area is tender (in the acute phase). While these tools are used in the treatment of other conditions, they should not be employed until the patient’s condition allows for their use. Eventually, in the chronic phase, these techniques may become an appropriate aspect of treatment. The chronic phase of the disorder is when there is tenderness which is localized at the anterior portion of the shoulder, the patient experiences pain when sleeping on that side of the body, and there is a feeling of what could be described as “catching” during active elevation of the shoulder.7
Find out more information regarding treating the rotator cuff.