The process of deposition of calcium salts in soft tissues is pathological. If it lasts for a long time, it is considered irreversible. It can affect all soft tissues without exception, in the cells of which degenerative and atrophic processes occur.
Calcification of the tendon is often a compensatory reaction after an injury against the background of total degenerative damage to the blood vessels. If, after a traumatic injury, the body does not have enough resources to fully restore the normal structure of the tissue, then in order to restore integrity, either the process of forming collagen scars consisting of connective tissue is started, or the deposition of calcium salts occurs.
Local calcification of tendons and muscles can be detected using x-rays, which show foci of pathogenic calcareous tissue. With calcification of ligaments and tendons at the initial stage, the patient experiences absolutely no clinical symptoms. This is due to the fact that the process occurs against the background of other pathologies and their symptoms always come to the fore. Then, as the focus of calcification develops, calcification encapsulates or grows. With a total process, even complete or partial impairment of motor function may be observed.
Over time, petrification can form - this is calcification of foci, inside of which a hidden cavity forms. It can fill with fluid, blood, pus and lead to a constant chronic inflammatory process in the human body, which significantly reduces the efficiency of the immune system.
Calcification begins as a degenerative process in the cells of tendons, ligaments or muscles. They can be provoked by injuries, dystrophy, disruption of the flow of blood and lymphatic fluid, infectious effects, and metabolic factors. In these local foci, the acid-base balance changes. There is a need to restore it by attracting additional calcium salts. The higher the acid reaction that accompanies the process of tissue breakdown, the higher the concentration of calcium in the intercellular space. Thus, the primary deposition of lime occurs in order to normalize the acid-base balance.
When the process of microcirculation of blood and lymphatic fluid is normalized, calcifications from soft tissues are effectively washed away within 10–15 days after the inflammatory process subsides. if blood flow is not restored, then calcifications strengthen and encapsulate.
Old calcification of ligaments and tendons can be eliminated only with the help of manual therapy. Surgical methods for removing foci of calcium salt deposits are also used. but they do not give a positive result, since after calcification is removed, a pathological cavity remains, which can be refilled with lime salts.
Development mechanism
This process is local, that is, it affects a specific area. The main cause of calcification is tissue changes that provoke increased absorption of calcium (lime) from tissue fluid and blood. The main factor in the development of this process is the alkalization of the environment, as well as an increase in the activity of enzymes that are released from dead tissue. With the dystrophic type of calcification, the formation of petrificates (accumulations of lime of various sizes and having a stone density) occurs in the tissue.
Petrification occurs in:
- chronic inflammatory foci;
- tuberculous necrotic foci;
- places of cell death;
- gummah;
- heart attacks.
In case of petrification, “armored lungs” are observed on the pleura, and “armored heart” is observed on the pericardium.
Metabolic calcification
Metabolic calcification (lime gout) is characterized by the fact that calcium salts are not retained in the blood and tissue fluid even at low concentrations and lime begins to be deposited along the tendons, in the muscles, skin, subcutaneous tissue, nerves, and blood vessels. Until now, the mechanism of development of metabolic calcification is not clear, but hereditary sensitivity of tissues to calcium - calcergia, or calciphylaxis - plays a significant role.
The outcomes of lime deposits in organs and tissues are unfavorable, since lime does not dissolve, is encapsulated, and is sometimes released from the body as a result of suppuration.
Classification
1. According to etiology:
- traumatic;
- degenerative;
- inflammatory.
2. By localization:
- brain calcification;
- petrification of joints, ligaments;
- calcification of blood vessels and so on.
3. In accordance with the location of petrification in a particular system (part) of the body:
- calcifications in the tissues/organs of the heart and vascular system (circulatory and lymphatic);
- petrification in organs/tissues of the nervous system;
- respiratory organs;
- musculoskeletal system;
- genitourinary system;
- Gastrointestinal tract and glands;
- hematopoietic system and intrasecretory organs;
- other calcifications.
4. According to the x-ray picture:
- in the form of massive regional formations, which more often occupy part of the organ (calcification of the pericardium or pleura) or (less often) multiple petrifications (with ossifying progressive myositis);
- individual foci that can be multiple or single, large or small (calcified pulmonary tuberculosis foci, calcified lymph nodes, and so on);
- petrificates in the form of stones (pancreatic, bile, salivary, etc.)
It is worth noting that both regional and focal calcifications can be organ (that is, located in one organ) or systemic (that is, present throughout the entire system).
5. In addition, calcification can be:
- physiological, that is, developing due to aging (involution);
- pathological, developing in places of various neoplasms.
Calcification of the ligaments of the knee and shoulder joint
The knee and shoulder joints are among the most loaded and mobile. These bone joints have a certain range of mobility and can withstand significant physical loads.
The stability of the knee joint is provided by two large cruciate ligaments (anterior and posterior). The lateral, internal and collateral ligaments provide stability to the patella and medial meniscus. Calcification of the joint ligaments begins after injury or inflammation. In the process of cell destruction, there is a need to restore the integrity of the structure. To solve this problem, collagen fibers of connective tissue and calcium salts are pulled into the lesion.
In most cases, calcification of the knee ligaments leads to their significant thickening and impaired mobility. To restore lost functions, comprehensive rehabilitation is necessary. The most important task for an orthopedist in such a situation is to restore the normal process of microcirculation of blood and lymphatic fluid in the lesion. If this can be done, then very quickly the foci of calcium deposits are cleared and filled with normal cellular composition, identical to the physiological structure of ligaments and tendons.
The ligaments of the shoulder joint are divided into two groups. The first includes the clavicular-humeral ligaments (acromio-clavicular, coracoclavicular, acromioclavicular, acromioclavicular) and provides reliable attachment of the head of the humerus to the clavioscapular region. The second group is the immediate humeral ligaments, located around the head of the humerus and providing stability to the joint during rotational movements of the upper limb. These are the upper, middle and lower shoulder ligaments.
Calcification of the ligaments of the shoulder joint can be caused by the following pathogenic factors:
- habitual shoulder dislocation and labrum deformity;
- sprains and ruptures of ligaments and tendons;
- humeroscapular periarteritis;
- deforming osteoarthritis of the shoulder joint;
- brachial plexitis and other types of innervation disorders;
- tendinitis, bursitis and other types of soft tissue inflammation.
Increased physical activity and an improperly organized place to sleep at night, which provokes a disruption of the blood supply to the tissues of the shoulder joint, have a negative effect.
Osteopathy and massage are used for treatment. The maximum effect is achieved by therapeutic exercises and kinesitherapy in combination with laser treatment on the affected tissues of ligaments and tendons.
Calcification of the pineal gland
Calcification is (as mentioned above) the formation of accumulations of undissolved calcifications in various organs or tissues in which such salts should not normally be contained.
The cause of pineal calcification can be congenital pathologies, various infections and metabolic disorders. Physiological calcification of the pineal gland is most often (40%) found in patients under 20 years of age. In this case, compact neoplasms with a diameter of up to 1 cm are formed in the organ.
In cases where calcifications are large in size, it is worth studying them in detail, as they can become the basis for malignant neoplasms. Dystrophic (pathological) calcification in the pineal gland occurs as a result of trauma, chemotherapy, ischemia, and so on, and is characterized by the deposition of cholesterol and lime in neoplasms.
Calcification of the pineal gland is accompanied by dysfunction of the latter, which can provoke the development of cancer, multiple sclerosis and schizophrenia due to blockade of melatonin synthesis. Filling of the pineal gland (calcification) with calcifications increases the likelihood of developing nervous exhaustion, anxiety, depression and gastrointestinal pathologies.
Metastatic calcification
Metastatic calcification (calcareous metastases) is systemic in nature and is accompanied by the deposition of calcium salts throughout the body in various organs and tissues. The cause of its development is hypercalcemia. The reasons for the increase in the concentration of calcium in the blood plasma may be increased leaching of calcium from the bones, decreased excretion of calcium from the body, or a violation of the hormonal regulation of calcium metabolism. For example, with hyperproduction of parathyroid hormone or lack of calcitonin, hypervitaminosis D.
An inflammatory reaction occurs around the deposits of calcium salts, and sometimes foreign body granulomas are formed.
Ligamentous calcification
Calcification of ligaments is a fairly common occurrence associated with age-related changes in the body, injury and inflammation. Ligamentous calcification is often asymptomatic and discovered incidentally during X-ray examinations.
Such involutive processes in cartilage and ligaments during calcification of joints are accompanied by a loss of shock-absorbing properties, plasticity and elasticity in the joints.
Most often, tendon calcification develops in the spine (cervical/lumbar spondylosis deformans), due to tears in the area where the annulus fibrosus and longitudinal vertebral ligament attach to the edge of the vertebra, as a result of which the intervertebral disc is displaced, tearing the ligament away from the vertebra. This is where calcifications/ossifications develop.
In addition, similar processes are often found in the spinal-costal joints (ribs 9-10), hip and phalangeal joints (Eberden and Bouchard nodes), being a local demonstration of the aging of the body.
Calcification of the spinal ligaments
The process of calcification of the ligaments that ensure the stability of the vertebral bodies often begins against the background of a long-term dystrophic degenerative disease. Everything in the spinal column is determined by three types of ligaments: the anterior longitudinal, posterior longitudinal and many short yellow ligaments that connect adjacent vertebral bodies.
All of them have a high degree of elasticity. Each type of lesion has a number of distinctive features:
- the anterior longitudinal ligament of the spine often suffers from osteoporosis, postural disorders, spondyloarthrosis and ankylosing spondylitis, calcification manifests itself with limited mobility and the appearance of a crunching sound when moving);
- the posterior longitudinal ligament of the spine suffers to a greater extent from age-related degenerative processes and its calcification can lead to a decrease in a person’s height and the inability to hold the back straight for a long time;
- The yellow short ligaments of the spinal column undergo calcification most often locally - against the background of the development of protrusion of the intervertebral discs (the more they lose their physiological height, the more the ligament between them calcifies).
When calcification of the spinal ligaments occurs, patients develop the following clinical picture:
- pain when bending forward, backward, in different directions;
- increased fatigue of the muscles of the back, neck and collar area;
- impaired range of motion in the cervical and lumbar spine;
- the appearance of crunching, clicking and squeaking noises when performing movements;
- decrease in physical endurance.
During an X-ray or MRI examination, the images show foci of characteristic calcification with thickening and increased tissue density. Treatment is carried out exclusively by conservative methods. Surgical intervention is absolutely ineffective.
Typical causes of calcification of the spinal ligaments are:
- osteochondrosis and its complications, such as protrusions and herniated discs;
- spondyloarthrosis and spondylosis deformans;
- Ankylosing spondylitis (ankylosing spondylitis);
- scoliosis and other types of curvature of the spinal column;
- osteoporosis and destruction of intervertebral discs;
- back injuries, including compression fractures.
The negative influence of heredity cannot be ruled out - often the development of calcification of the spinal column is observed simultaneously in the older and middle generations of the same family.
Spurs
Calcification of tendons at the points of their attachment to bones, which look like spikes and points, are called spurs. Similar formations occur in the pelvic, ulnar, occipital, and calcaneal bones.
The cause of calcification in this case is inflammatory processes, physical activity and age-related changes. The most common diagnosis is a heel spur (at the insertion of the Achilles tendon).
The formation of spurs is often accompanied by pain and limitation of movement; radiographs show deformities of the foot, replacement of soft tissues with fatty tissues and transformation of tendons into bone tissue.
Calcification of heart valves
- Calcification of the aortic valve. The cause of this disease is rheumatic valvulitis, leading to degenerative changes in tissues. In this case, the valve flaps are deformed and soldered together. At the same time, calcifications form on them, which block the aortic ostium. In some cases, the process extends to the interventricular septum, the mitral valve leaflet and the wall of the ventricle (left). As a result, aortic insufficiency develops.
- Calcification of the mitral valve. It is quite difficult to diagnose such a pathology, due to the fact that its symptoms are similar to the clinical picture of cardiosclerosis, hypertension and rheumatism. More often this disease is detected in elderly patients.
Vascular calcification
- Calcification of the aorta. Develops in patients over 60 years of age. The clinical picture of the disease depends on the level of vessel damage.
- Calcification of cerebral vessels. Calcification is in this case a synonym for atherosclerosis. Due to the accumulation of lipids on the walls, insufficiency of blood circulation in the brain occurs, which is fraught with the development of strokes, dementia, and so on.
- Calcification of the coronary arteries. In this case, cholesterol and fats settle on the walls of these vessels, that is, atherosclerotic plaques are formed, which leads to a loss of elasticity and a change in the shape of the vessel, as a result of which the blood supply to the myocardium is disrupted, and in the case of complete blockage of the lumen, tissue necrosis.
Brain calcification
Calcinosis can affect various brain structures:
- cerebral cortex;
- cerebral vessels;
- hard shell.
Such changes develop due to various reasons, the main of which are:
- Past or existing infections (tuberculosis, cysticercosis, HIV).
- Intrauterine (congenital) infections (TORCH).
- Injuries.
- Atherosclerosis.
- Inflammation.
- Tumors.
- Metabolic, endocrine disorders.
Calcification: treatment
Therapy for calcification depends on the location and extent of the process, as well as the severity of symptoms and the age of the patient.
- To normalize calcium metabolism, it is recommended to restore the balance of calcium and magnesium in the blood. Magnesium controls the flow of calcium and dissolves calcifications, and also promotes the removal of excess microelements and its proper absorption. Therefore, in addition to diuretics, the patient is recommended to take magnesium supplements.
- Dieting. The patient should avoid foods that are fortified with calcium (vegetables, milk, etc.) and vitamin D.
- In the case of massive foci of calcification (in particular on the skin and subcutaneous tissue), surgical treatment is recommended.
- Early detection of pathology promotes a speedy recovery and is the prevention of serious complications. As mentioned above, therapy depends on the location of the calcification focus.
- In some cases, patients are recommended to use folk remedies, but such therapy should be carried out strictly under the supervision of the treating doctor.
- Treatment of mitral valve calcification is carried out using mitral commissurotomy, as well as prescribing preventive drug treatment. Thanks to these methods, cardiac activity is restored and the patient can lead a normal active lifestyle.
- To slow down calcification of the aorta, therapy with drugs based on statins, nicotonic acid, and so on is used. In the case of an advanced process, surgical interventions are used.
Treatment of calcification of ligaments and tendons
When calcification of the tendon occurs, treatment begins with eliminating the action of the pathogenic factor. Thus, if the deposition of calcium salts is provoked by aseptic tissue necrosis in the area of the bone heads, then it is important to carry out comprehensive treatment of the disease that provoked the onset of ischemia. Then the doctor will prescribe an individual recovery course, which allows you to eliminate calcium salts from soft tissues and start the process of natural regeneration of cells identical to tendon and ligament tissue.
Manual therapy is most effective in treating ligament calcification. Our manual therapy clinic uses the following methods:
- osteopathy and massage to improve the processes of microcirculation of blood and lymphatic fluid - this starts the process of removing calcium salts from the focus of calcification;
- reflexology is used as a targeted treatment to start the process of tissue regeneration using the internal hidden reserves of the human body;
- therapeutic exercises ensure rapid removal of calcium salts from ligaments, tendons and muscles;
- kinesiotherapy restores the range of mobility in the joints and spinal column;
- traction traction of the spine allows you to increase blood flow in the longitudinal and yellow ligaments, improve their elasticity and ability to stretch;
- Laser therapy and other physical therapy methods are used to speed up the healing process.
If you require treatment for calcification of ligaments, tendons and muscles, you can schedule a free initial consultation with an orthopedist, vertebrologist or osteopath at our manual therapy clinic. During the first consultation, the doctor will conduct a full examination, review the medical documentation, and give individual recommendations for complex treatment.