Calcific Tendinopathy of the Shoulder

Calcium deposits in your shoulder causing severe, unpredictable pain?

Calcific tendinopathy is one of the few shoulder conditions where focused shockwave therapy has particularly strong evidence behind it. What makes our approach different is that we image the deposit first - identifying whether it’s hard or soft, which directly determines whether shockwave is appropriate and how it should be delivered. No other clinic in West Wales offers this level of pre-treatment assessment.

What is calcific tendinopathy?

Calcific tendinopathy of the shoulder is a condition in which calcium deposits develop within one or more of the rotator cuff tendons. The supraspinatus tendon is most commonly affected. The calcium deposits can vary in size, consistency, and behaviour, and are often detected incidentally on imaging in people with no or minimal symptoms. When symptomatic, calcific tendinopathy can cause significant pain - sometimes severe - particularly during certain phases of the condition. The natural history is broadly favourable, with many cases resolving over time, but some deposits persist and cause ongoing pain and functional limitation without targeted treatment.

Who does it commonly affect?

Calcific tendinopathy most commonly affects adults between the ages of 30 and 60 and is more prevalent in women than men. It may be associated with:

Repetitive shoulder loading or overhead activity
Metabolic conditions including thyroid disorders and diabetes
A history of previous shoulder injury or rotator cuff pathology

Calcium deposits are present in the tendons of many adults and do not always cause pain.

Common Symptoms

Symptoms vary depending on the phase of the condition:

Pain in the shoulder, often sharp or severe, particularly at night
Significant restriction in shoulder movement during acute flare-ups
Pain when lifting the arm out to the side or reaching overhead
Tenderness over the front or top of the shoulder
In severe cases, rapid onset of intense pain that can limit all shoulder movement

Between episodes, individuals may have relatively mild symptoms or none at all.

How is calcific tendinopathy usually treated?

Management depends on the phase and severity of the condition. Options include:

Activity modification and load management during acute phases
Analgesic and anti-inflammatory measures for acute pain relief
Targeted rotator cuff and shoulder strengthening exercises
Focused shockwave therapy, commonly used as part of a structured care pathway for persistent deposits
Referral to an appropriate specialist if further intervention is required

Focused shockwave therapy is more comfortable than radial shockwave therapy and typically requires fewer sessions

Why our approach is different

Accurate imaging is central to the management of calcific tendinopathy. At Tenby Health & West Wales Ultrasound, we use diagnostic ultrasound to assess deposits directly - identifying their location, size, and consistency. Hard and soft deposits respond differently to treatment, and this information directly informs the care plan.

Where focused shockwave therapy is indicated, it is combined with:

A structured clinical and ultrasound assessment
Shoulder rehabilitation exercises to maintain and restore function
Clear guidance on what to expect from treatment and the expected course of recovery
Referral to an appropriate specialist where further intervention may be needed

What to do next

If shoulder pain or suspected calcific tendinopathy is affecting your daily life, the most important first step is a proper assessment.

Book a new patient consultation (£65) and we’ll assess your symptoms, confirm the diagnosis, and explain your options clearly - whether that’s shockwave, rehabilitation, diagnostic ultrasound, or a combination. Most people leave their first appointment knowing what’s going on for the first time.