Calcific shoulder tendinitis occurs when calcium builds up in the tendons of the shoulder. The tissues around the calcium deposits become inflamed, resulting in severe pain. This disease is quite common and most often occurs in people over 40 years of age. Calcific tendonitis occurs in the rotator cuff tendons. The rotator cuff is made up of several tendons that connect the muscles around the shoulder to the humerus. Calcium deposits usually form on the rotator cuff tendon, called the supraspinatus tendon.
There are two different types of calcific shoulder tendonitis: degenerative calcification and reactive calcification. The wear and tear processes of aging are the main cause of degenerative calcification. As we age, the blood supply to the rotator cuff tendons decreases, causing the tendons to weaken. The wear process is accompanied by microtears of tendon fibers. And in damaged tendons, simultaneously with regeneration, processes of calcification deposition occur.
Reactive calcification is different from degenerative calcification. The mechanism of development of this type of calcification is not completely clear. This type of calcification is not associated with degenerative changes and is much more likely to cause shoulder pain than degenerative calcific tendonitis. The development of reactive calcific tendonitis is believed to occur in three stages. In the initial stage of calcification, changes occur in the tendons, which create conditions for the formation of calcifications. During the calcification stage, calcium crystals are deposited in the tendons. But at this stage, calcifications are resorbed (reabsorbed) by the body. It is at this stage that pain is most likely to appear. In the post-calcification period, the body repairs the tendon and the damaged tissue is replaced with new tissue. The mechanism that triggers the absorption of calcifications into the body is not clear, but once this occurs and the tissue begins to regenerate, the pain usually decreases or disappears completely.
Causes
No one knows what exactly causes calcific tendinitis. Physical stress, aging or a combination of both leads to degenerative calcification. Some researchers suggest that calcium deposits are formed due to tissue hypoxia and insufficient oxygen supply to the tendon tissues. Others believe that pressure on the tendons can lead to their damage, resulting in the deposition of calcium deposits.
The mechanism of formation of reactive calcification has not been completely studied. Typically, this type of calcific tendinitis occurs in younger patients and occurs without any apparent cause.
Diet
- In addition to following the normal distribution of physical activity, a proper diet will also help prevent salt deposition. The patient is recommended to drink plenty of fluids, up to two liters per day.
Exceptions include strong teas, coffee and alcoholic drinks. The potential patient is advised to reduce the level of carbohydrates consumed in food. Also, you should avoid consuming large amounts of table salt.
- If you have salt deposits in the joint, it is better to exclude salt from your diet. Moreover, it is recommended to divide food into small but frequent portions. A person should eat five or six times a day.
Fried, spicy, salty dishes are excluded. Meat should only be consumed boiled or baked. When dieting, you should not eat tongue or brains. The consumption of dairy products, fruits and vegetables is not limited. An exception in fruits is grapes due to the increased content of mono- and disaccharides.
The sugar content in the daily diet should be no more than thirty grams.
Diagnostics
To diagnose calcific tendonitis of the shoulder, your doctor will first take a medical history and perform a physical examination. Shoulder pain can be associated not only with calcific tendonitis, but also with other diseases. Therefore, to make an accurate diagnosis, instrumental studies are necessary. Radiography allows one to visualize the presence of calcium deposits in the tendons. But the most informative way to visualize ligaments and tendons and the presence of pathological changes in them is MRI (magnetic resonance imaging). Visualization of calcifications using radiography or MRI in dynamics allows you to determine treatment tactics (conservative or surgical treatment). Laboratory tests are necessary in cases where it is necessary to differentiate this disease from inflammatory diseases of connective tissue.
How to remove widow's hump at home
The first thing that is recommended when deciding how to remove a widow’s hump is exercise. Taking into account the main reason for its development (stooping, prolonged static position), regular loads on the neck and shoulders, upper back and abs will help normalize posture. But it is important to remember that exercises for widow’s hump at home can be performed only after the doctor’s permission, after undergoing an examination that excludes osteoporosis and more serious causes of the development of the defect.
There are quite simple and effective exercises to eliminate the widow's hump. By strengthening the right muscles, you can prevent and correct this terrible condition. The exercises use the body's own resistance to strengthen and tone the key muscles of the upper back. When these muscles are strong, they keep the cervical vertebrae level and prevent the head from moving forward. And the exercises themselves stimulate the growth and density of bones in the vertebrae.
The workouts work the posterior deltoid, rhomboid and middle trapezius muscles. To straighten your hump, you will need only two light weights: for example, 2 dumbbells of 2 kg each or plastic bottles of water.
- Stand with your feet shoulder-width apart and hold one weight in each hand.
- Lean forward at your hips at about a 45-degree angle. Extend your arms in front of you.
- Squeezing your shoulder blades, raise both arms up and out to shoulder level. Your elbows should be slightly bent. Slowly lower your arms back to the starting position. Repeat 8 times in 1 set.
- Do 3 sets of 8 reps or as many as you can.
During exercises, do not raise your arms above shoulder level. You can do this exercise seated if you prefer - just keep your back straight and lean forward at the hips, bringing your chest down to your knees.
Treatment
Conservative treatment
The main goal of conservative treatment is to reduce inflammation and pain. Therefore, at the first stage, conservative treatment includes rest and taking NSAIDs (ibuprofen). Anti-inflammatory drugs can reduce the inflammatory process and reduce pain. If severe pain is present, corticosteroid injections may be prescribed. The use of steroids can effectively relieve swelling and inflammation for some time.
During the period of time when calcium deposits begin to be reabsorbed, pain can be especially severe. In such cases, it is possible to remove part of the calcium deposits using saline rinsing. solution through two punctures in the area of calcium deposits. This procedure is called lavage. Sometimes with this procedure it is possible to break the calcifications into pieces (they are removed with a needle). Removing deposits allows you to quickly reduce pain and achieve faster tendon recovery. Even when lavage does not remove calcium deposits, it can relieve pressure in the tendons, resulting in less pain.
Physiotherapy . Physiotherapy is one of the main components of the conservative treatment of calcific tendinitis. The use of a technique such as ultrasound helps reduce pain and inflammation. But the effect of using ultrasound is achieved only with a course of treatment (up to 24 procedures over 6 weeks). Shock wave therapy is currently the most modern method of conservative treatment of such diseases. The shock wave breaks down large calcium deposits, allowing the body to absorb them more quickly.
Exercise therapy is indicated at the stage of completion of reabsorption and allows you to restore muscle tone and improve blood supply to the structures of the shoulder. As a rule, an individual selection of exercises is carried out and exercise therapy is carried out for 4-6 weeks. Exercise is important to strengthen the rotator cuff muscles, as these muscles help control the stability of the shoulder joint. Strengthening these muscles can actually reduce the pressure on the calcium deposits in the tendon.
Symptoms
Symptoms of salt deposits resulting from the above factors include:
- Dull, constant pain
- Painful sensations when touching the shoulder joint where the muscle attaches to the bone
- The occurrence of pain at the slightest physical exertion
- The appearance of pain in the shoulder area at night
If the deposit has affected the entire tendon, then the following symptoms may be added to the above symptoms:
- Localized redness
- Temperature increase
- Swelling in the shoulder area
Surgery
If conservative treatment is ineffective and shoulder function deteriorates or there is persistent pain, surgical treatment is recommended. As a rule, surgical treatment is carried out using a minimally invasive atroscopic method, which allows the patient not to stay overnight in the surgical department. During an atroscopic operation, the surgeon visually determines the localization of calcium deposits in the tendons of the rotator cuff, removes them and washes this area; free calcium crystals, which can irritate the surrounding tissues, are also removed.
In rare cases, open surgery may be necessary. With this operation, access to calcium deposits is through an incision in the muscles of the ligaments with the removal of part of the tendons. After removing the deposits, the muscles and tendons are sutured.
Rehabilitation after shoulder surgery can take quite a long period of time. In the first 6-8 weeks after surgery, it is recommended to wear an orthosis and limit movements, then it is necessary to gradually begin to develop the joint and combine physiotherapy with exercise therapy. The volume of loads on the joint must be increased gradually and very carefully under the supervision of a physical therapy doctor. Exercises usually begin no earlier than 6 weeks after surgery. The exercises are aimed at improving the muscle strength of the shoulder girdle and rotator cuff muscles. Full recovery of shoulder function after surgery may take 3 to 4 months. After open surgery, recovery is much slower than with atroscopic resection.
Causes of salt deposition in joints
The main factors that can cause the deposition of uric acid salts include: deterioration of metabolic processes in the joints and disruption of the urinary system.
Also, salt deposits in the knee or shoulder joint can be caused by the following reasons:
- Unbalanced diet. If a person’s diet contains a large amount of fatty, spicy or fried foods, this over time leads to an increase in body weight and disruption of the process of removing uric acid;
- Disruption of normal blood flow. Due to reduced physical activity, muscle tissue degeneration occurs and, as a result, salt deposits accumulate. The risk group includes schoolchildren, students, as well as people who, due to their profession, lead a sedentary lifestyle;
- Endocrine disorders. We are talking about malfunctions in the functioning of water-salt metabolism, which is a consequence of disruption of the activity of the endocrine glands;
- Abuse of tobacco products and alcoholic beverages;
- Increased stress on joints. Performing dangerous stunts by athletes and wearing high-heeled shoes by women;
- Thermal impact. The risk group includes people whose activities involve daily exposure to the cold, for example, builders.
A healthy body is able to cope with excess deposition of uric acid salts. However, if the metabolic system is disrupted, salt crystals can provoke serious degenerative changes in the body.
Could this be due to the deposition of calcium salts?
Often pathological processes in tissues occur against the background of calcification. We are talking about the process of deposition of calcium salts in the joints, which is caused by disruption of the parathyroid glands. The disease can also be triggered by pathologies in the kidneys and bones, and D-vitamin intoxication.
There are two types of disease:
- Metabolic calcification. It occurs due to local deterioration of metabolic processes in tissues. In this case, the appearance of salt deposits in the skin and muscle tissue is observed;
- Metastatic calcification. It can be triggered due to the accumulation of salt in the internal organs and on the vascular walls.
Thus, if a normal amount of salts is present in the human body, they are in liquid form and take part in metabolic processes. When they are in excess, salt build-ups form in blood vessels and tissues.
As a rule, salt deposits are found in the area of large joints, lower and upper extremities, as well as teeth and ears. Areas with pathological growths are characterized by increased density and mobility, but upon palpation they do not cause discomfort. The skin over them has significant tension, but there is no inflammatory process. Gradually the formations soften, and lime is released from them.
Gout
This is a disease that is characterized by metabolic disorders and an increase in the concentration of uric acid salts in the blood and joint tissues. The deposition of urate crystals in the connective tissue membrane that protects the joint eventually leads to the occurrence of inflammatory processes.
The following forms of gouty arthritis are distinguished:
- Primary. Caused by the genetically atypical structure of protein compounds responsible for the exchange of uric acid and its salts;
- Secondary. It appears against the background of lichen planus, congenital defects in the structure of the heart, renal failure, chronic myeloid leukemia and other pathologies.
Gouty arthritis is characterized by sudden pain that occurs at night. In this case, the metatarsophalangeal joint of the 1st toe is affected. This pathological process may be accompanied by redness and blueness of the skin and an increase in body temperature. The attenuation of the inflammatory process is observed after a few days, but relapses are possible.
In mild forms of the disease, the patient feels only minor discomfort and slight redness in the joint area. In addition to the first toe, salt deposits can be observed in the wrist or elbow joint.
In advanced stages of the disease, polyarthritis may occur, and yellow nodular formations containing uric acid salts may occur in the pathological area.
Osteoarthritis and salt deposition
Often, patients suffering from osteoarthritis believe that they have normal salt deposits. However, age-related changes inherent in deforming arthrosis differ sharply from the manifestations of this disease. Joint hardening occurs due to the growth of bone tissue located under the cartilage. What is the reason for this?
Since cartilage has a shock-absorbing function, it is constantly exposed to shock, which provokes thickening of the bone in this area. In addition, during movement the joint is subjected to stress, which is accompanied by injury to certain areas. This leads to the appearance of bone growths and spines. As a result, the cartilage loses its ability to absorb and slide, and is destroyed over time.
To eliminate the pathology, a synovial fluid endoprosthesis (Noltrex) is injected into the joint. The main purpose of the drug is to increase the space between worn-out cartilaginous structures and restore the functionality of the joint.