Calcific tendinitis of the shoulder: when pain strikes without warning
Sudden, severe shoulder pain, sometimes in the middle of the night, with no preceding injury at all - clinically different from ordinary tendon inflammation.
Calcific tendinitis of the shoulder causes sudden, severe pain, sometimes in the middle of the night, with no preceding injury at all - completely different from ordinary tendon inflammation, and more common in women aged 30–50.
If you woke in the middle of the night with sharp, unbearable shoulder pain, with no fall or injury to explain it - this may be calcific tendinitis of the shoulder, a condition in which calcium deposits build up inside one of the shoulder tendons, usually the supraspinatus tendon.
This is an entirely different condition from “ordinary” tendon inflammation or a rotator cuff tear, and despite the dramatic pain it can cause, in most cases it responds well to conservative treatment.
How does it usually feel?
Symptoms can vary, but many describe:
- Sudden, severe shoulder pain, sometimes with no preceding event at all.
- Pain that worsens significantly at night and disturbs sleep.
- Significant difficulty with any shoulder movement, even the smallest.
- Sometimes also prolonged phases of duller, milder pain.
- Focal tenderness at the front-upper part of the shoulder.
If the pain comes on with extreme suddenness and unusually high intensity, with no story of injury at all - that is exactly the feature that distinguishes active calcification from most other shoulder problems.
What causes calcific tendinitis of the shoulder?
The precise cause of the calcium deposits building up in the tendon isn’t fully known, but the condition is known to be more common in women aged 30–50. The most severe pain appears specifically at the stage when the body begins to reabsorb the calcium deposits and produces a strong inflammatory response - not at the stage when the deposit forms.
How can physiotherapy help?
In the acute stage, treatment focuses on reducing the pain and preserving as gentle a range of motion as possible, without loading the inflamed tendon. In most cases, once the body finishes absorbing the calcium deposit, the pain decreases significantly on its own - and then gradual rehabilitation of strength and full range of motion begins.
Sometimes, in particularly painful cases, an injection is needed for temporary relief alongside the physiotherapy treatment.
When should you get checked?
If the pain is especially severe and long-lasting with no relief at all, or comes with fever and marked redness - see a doctor to rule out infection, and consider imaging to confirm the diagnosis.
Frequently asked questions
No, there is no proven link between diet or calcium intake and the appearance of calcification in a tendon.
In the overwhelming majority of cases no - the body absorbs the deposit itself over time, and surgery is reserved for rare cases that have not responded to treatment.
In most cases, no. Once the deposit has been fully absorbed, the likelihood of recurrence in that same tendon is low.
What’s worth remembering?
Calcific tendinitis of the shoulder is frightening in the intensity of its pain, but in most cases it resolves on its own over time - treatment focuses on managing the pain and preserving movement until the body completes the process.
- Calcific tendinitis of the shoulder is caused by calcium deposits building up in a shoulder tendon, usually the supraspinatus, and is more common in women aged 30–50.
- The most severe pain appears specifically at the stage when the body reabsorbs the calcium deposits, not when they form.
- Despite the dramatic pain, in most cases the condition responds well to conservative treatment.
Not sure if this is your situation? I’d be happy to give you a professional assessment and build a treatment plan that fits you.
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