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Calcific Tendinitis

The rotator cuff are a group of tendons and muscles that surround the shoulder joint. Calcific tendinitis is a condition where these tendons develop calcium deposits inside and on the surface of them.

It can be exquisitely painful with many patients brought to tears with the sheer intensity  of the pain.

The cause of the condition is still unknown but generally happens to people in middle age. It does disappear spontaneously, however this can take up to 10 years to occur.
Patients report pain and a dull ache, which can become very severe, around the side of the shoulder which moves down the side of the arm towards the elbow. Motion can be restricted with difficulty lifting the arm above the head especially with repetitive overhead activities. Sleep is generally disturbed with patients often unable to lie on the affected side at night with the pain causing people to wake up several times.
When you come to clinic a thorough history and examination is usually sufficient to diagnose the problem. You will be sent for an Xray and occasionally an ultrasound or MRI scan will be required to confirm the diagnosis.

Physiotherapy

Calcific tendinitis requires focussed physiotherapy rehabilitation.

Steroid Injection

This maybe assisted with a steroid injection into the bursa, which reduces the pain to help with physiotherapy.

Dry Needling (Barbotage)

If the calcium deposit is large enough you will be referred for Dry Needling (Barbotage) of the calcium deposit. This is performed by a Consultant Musculoskeletal Radiologist. It involves the injection of local anaesthetic into the skin and insertion of a needle into the calcium deposit. The radiologist can either break up the calcium and sometimes suck the calcium into a syringe.

Surgery

In most cases of calcific tendinitis this is enough to settle the pain, however on occasion the pain many continue and you will require
surgery.

Surgery for excision (removal) of calcium deposits involves keyhole surgery and is performed as a day case procedure. On most occasions the calcium can be completely removed from the tendon. However, if the calcium is either widespread or extremely hard and embedded within the substance of the tendon, a complete excision cannot be guaranteed.

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Shoulder problems including pain, are one of the more common reasons for clinic visits for musculoskeletal symptoms. The shoulder is the most movable joint.

Aftercare

Following the operation, you will normally have a bulky dressing covering your wound. This is then removed to reveal the sticky dressing at 48 hours until 14 days following your operation. The stitches will dissolve and do not require removal. You will require a wound check either at the hospital or your GP practice at 14 days.

Surgery for calcium excision is quite painful and many patients report and increase in pain for a few weeks after surgery. After 6 weeks the pain starts to settle. It can take from 6 weeks to 12 months to recover from the surgery. Every patient is different hence the large variation of rehabilitation time.

This depends on the nature of your work. For a sedentary occupation the time off is normally 2-6 weeks. For a manual occupation this can be as long as 3-4 months.
It is normally safe to drive within 6-8 weeks of your operation but can take up to 12 weeks before you are completely comfortable to start driving.
This depends on the intensity of the sport and can range from 6 weeks to 3 months off.

Stiffness

Due to pain after surgery, patient may be reluctant to perform their exercises. If you do not gently rehabilitate your shoulder it can become stiff and you can develop a frozen shoulder.

Anaesthetic Risk

Anaesthetic in the modern era are extremely safe however there are still minor risks associated with the different techniques which the anaesthetist will discuss with you before your surgery.

Infection

(1%) is a risk with all surgery.  In the majority of cases these are infections around the wound and can be treated with a course of  antibiotics.  The more unusual deep-seated infections however can require admission to hospital and surgery to clean the wound out if necessary.

Nerve Injury 

Is a potential but very rare risk with this surgery.  Often the nerves at greatest risk are the tiny nerves supplying skin in the area of the wound and cutting through these may result in an area of numbness that is not often troublesome.

Recurrence 

Is a rare complication.

What our patients who have treated in our Clinic did say?

Patient
Patient
BMI The Beardwood Hospital
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From start to finish I received the utmost care and consideration from Mr Hadi. He took time to listen to my history and then go through the procedure with myself . The course of treatment provided was very effective as was the aftercare. I do not feel he could have done anymore.
Patient
Patient
BMI The Beardwood Hospital
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What a lovely man. Explained everything fully and gave me options regarding treatment including surgical repair which I opted for. I was treated with kindness and respect. The surgery was carried out efficiently and after care was superb. Would definitely recommend Mr Hadi.
Patient
Patient
Royal Blackburn Teaching Hospital
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Recently needed an operation on my shoulder. The treatment I received was second to none. Mr Hadi explained everything fully beforehand, making sure I was fully informed and again was exceptional in my aftercare and recovery. I felt supported and valued as a patient. Professional and approachable throughout. Highly recommend! Thank you.
Patient
Patient
BMI The Beardwood Hospital
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I could not have asked for better care. Excellent bedside manner, totally professional, would highly recommend.
Patient
Patient
BMI The Beardwood Hospital
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The information i was given during treatment was great, al my questions were answered in a way I understood. I was never made to feel my questions were stupid. Really great experience
Patient
Patient
BMI The Beardwood Hospital
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Mr Hadi has a real understanding of making patients feel assured and at ease at all stages of treatment. He explains the pros and cons of the procedure and gives you time to decide if you want to go ahead
Patient
Patient
BMI The Beardwood Hospital
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I have had a few operations over the years on my shoulder, and I didn't see results straightaway, I was told it may not improve at all, however last year I underwent another operation on my shoulder. 12 months later I am less pain now than I was from my original operation in 2008.
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