Calcific Tendinitis Shoulder Treatment London

Overview

What is Calcific Tendinitis?

Calcific tendinitis (also commonly written as calcific tendonitis) is a condition in which calcium deposits build up within the tendons of the rotator cuff — most commonly in the supraspinatus tendon. These deposits can cause significant shoulder pain, particularly when the arm is raised above shoulder height or during everyday activities such as reaching or dressing.

The condition progresses through recognised phases. During the formative phase, calcium is deposited gradually and may cause little discomfort. During the resorptive phase — when the body begins to break down the deposit — pain can become severe and often acute, arising with little warning. This is the phase in which most patients seek urgent specialist review.

Calcific tendinitis is more common in women and typically affects people between the ages of 30 and 60. It can occur in the absence of any obvious injury or overuse.

Symptoms

Symptoms vary considerably depending on the phase of the condition. Common presentations include:

Sudden onset of severe shoulder pain, sometimes described as the worst pain the patient has ever experienced

Deep, aching pain in the shoulder that is worse at night

Pain and restriction when lifting the arm or reaching overhead

Tenderness directly over the front or side of the shoulder

Reduced range of movement, particularly rotation

In the acute resorptive phase, the pain can be so intense that even resting the arm is uncomfortable. Many patients report being unable to sleep on the affected side.

Diagnosis

An accurate diagnosis requires specialist assessment. Professor Kochhar uses a combination of clinical examination and imaging — typically ultrasound and plain X-ray — to confirm the presence of calcific deposits, identify the phase of the condition, and exclude other causes of shoulder pain such as a rotator cuff tear or acromioclavicular joint pathology.

Ultrasound is particularly valuable as it allows dynamic assessment of the deposit and guides any subsequent treatment procedures.

Treatment

Treatment Options

Conservative Management

In many cases, calcific tendinitis will resolve without surgical intervention. Initial management focuses on pain relief, protecting the shoulder from aggravation, and maintaining movement. This may include anti-inflammatory medication, physiotherapy, and in some cases, a carefully targeted injection to reduce bursal inflammation during the acute phase.

Professor Kochhar's approach is that most patients do not need surgery — but all patients deserve an accurate assessment and a treatment plan tailored to their individual clinical picture.

Ultrasound-Guided Barbotage

Most Effective for Persistent Deposits

For patients whose calcium deposit is persistent or causing significant symptoms, ultrasound-guided barbotage is a highly effective, minimally invasive procedure. Under real-time ultrasound guidance, a fine needle is introduced into the calcium deposit and a saline solution is used to break up and aspirate the calcium. This is often combined with a low-dose corticosteroid injection into the subacromial bursa to reduce post-procedural inflammation.

Most patients experience significant improvement within four to six weeks of barbotage, and many see their calcium deposit reduce substantially or resolve entirely. The procedure is performed as an outpatient and requires no general anaesthetic.

Physiotherapy

Physiotherapy plays a central role at all stages of calcific tendinitis management. Following any injection procedure or barbotage, a structured rehabilitation programme helps restore range of movement, strengthen the rotator cuff, and reduce the risk of recurrence.

Surgical Treatment

Surgery is reserved for the minority of patients in whom conservative measures and barbotage have failed to provide adequate relief. Arthroscopic (keyhole) removal of the calcium deposit is a highly effective option in appropriate cases, and Professor Kochhar has extensive experience in this technique.

FAQ

Frequently Asked Questions

How long does calcific tendinitis last?

The natural history varies. Some cases resolve over several months as the body reabsorbs the calcium. Others persist for years without specialist intervention. The acute resorptive phase is typically the most painful but may also represent the point at which the body is most actively working to resolve the deposit.

Is barbotage painful?

The procedure is performed under local anaesthetic and is generally well tolerated. Patients may experience a short-lived increase in shoulder discomfort in the days following the procedure — this is a normal part of the healing response and typically settles within one to two weeks.

Will it come back after treatment?

Recurrence after successful barbotage is uncommon. The underlying tendency to form calcium deposits can persist, so maintaining good rotator cuff strength through physiotherapy is beneficial long-term.

Do I need surgery?

The majority of patients with calcific tendinitis do not require surgery. Professor Kochhar's philosophy is to explore all appropriate non-surgical options first. Surgery is only recommended when other treatments have been tried and have not provided sufficient relief.

Why Choose Professor Kochhar

Expert Care You Can Trust

Professor Tony Kochhar is one of London's leading specialist shoulder and upper limb surgeons. He holds the prestigious FRCS (Tr. & Orth) qualification, is a member of the British Orthopaedic Association, and is a Visiting Professor at the University of Greenwich. He sees patients at London Bridge and across the West Kent area, and holds Doctify's 2026 Outstanding Patient Experience recognition.

His practice is built on the principle that early, accurate diagnosis leads to faster recovery — and that most patients, with the right specialist care, can avoid surgery altogether.

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