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Shoulder pain can be caused by a calcification of tendons in the rotator cuff.

Small calcium deposits form with the tendons of the shoulder’s rotator cuff. Most often the condition occurs in adults 30—40-years-old. Commonly, the deposits become painful and can restrict mobility of the shoulder. In minor cases, physical therapy or anti-inflammatory medications may be sufficient to address the problem until the calcifications break apart spontaneously. In severe cases, patients may require shock wave treatment or surgery to remove the calcium.

Sometimes the calcification breaks up on its own. Unfortunately, this can take from a few months to years, before the break up occurs, and in the meantime the patient suffers shoulder and possible restricted arm movement. Untreated, the calcification break up allows the calcium to spread along the tendon and lodges in the subacromial bursa, a fluid sac that helps lubricate the tendon. Calcium buildup in the tendon and bursa can cause bursitis, a painful condition with a long recovery time and a disabled shoulder.

Radiologists are now using a new minimally invasive procedure to treat tendonitis in the shoulder. The procedure was used on 2,543 shoulders  (1,607 women, 938 men, average age 42) with calcific tendonitis that had been unresponsive to previous medical treatment. A one-year follow-up of 2,018 of the patients confirmed the results.

The ultrasound-guided non-invasive therapy procedure required the patient’s shoulder to first be anesthetized. After the ultrasound treatment a saline solution was injected to wash out the area and break up the calcium. A second needle is used to withdraw the calcium residue. Typical recovery time is an hour. In 72% of the patients one treatment removed all of the calcification. With 23% of the patients a second treatment was required because there was calcification in more than one area. A small percentage, 4%, had spontaneous resolution, which caused the treatment to be unnecessary. Less than 1% of the patients could not be helped by this procedure because of the presence of tendon tear.

Currently, Ospedale Santa Corona and the University of Genova are among the few institutions currently offer this new therapy, but the procedure could be performed in any hospital or clinic that has ultrasound equipment with superficial probe. As people age shoulder pain becomes more common and calcium build-up is one cause. The ultrasound procedure can allow them to feel better immediately with little cost.

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