When tablets are no longer sufficient, I suggest infiltration of the subacromial space, which significantly reduces pain. Side-effects are limited (although there is a rise in blood sugar levels).
Diabetic patients should be warned, as this type of infiltration can cause blood sugar levels to rise sharply in the days that follow.
Physiotherapy with "shock waves" is one solution. The latest studies note a reduction in pain in 42% of patients, but only 15% consider the treatment successful.
This is a treatment effected mainly arthroscopically with trituration and aspiration of the calcium deposit.
Arthroscopic surgical removal provides a definitive cure in 80-90% of patients during a one-day hospital stay.
Physiotherapy sessions are recommended after one week, initially with passive mobilization.
Active mobilization of the shoulder can be authorized from the third post-operative week.
X-rays and ultrasound are required to confirm the diagnosis.
Pain is the main symptom. It may be perceived as a simple discomfort associated with certain movements, or it may be continuous, with nocturnal exacerbations. During a major pain crisis, when calcifications irritate the subacromial bursa, the pain is excruciating and the patient can no longer move his arm. Conventional painkillers have little effect.
Calcifiant tendonitis of the shoulder involves the presence of calcifications in the enflammed tendons of the rotator cuffffe. Their existence is fairly common. Between 2.5% and 7.5% of radiographed shoulders have calcifications. Sometimes this calcification does not manifest itself and the patient does not complain of pain.
On the other hand, when the calcification breaks down, the calcium crystals migrate into the subacromial space and this migration causes a very sharp inflammation at the origin of an acute pain crisis.
Patients can no longer move their shoulder because of the intense pain.
Calcifications are deposits of calcium hydroxyapatite, which may also be present in other enflammed tendons (foot, elbow and hip tendons).
Involvement is often bilateral, and calcifications are more frequent in diabetics and dialysis patients.