My sister has terrible shoulder pain. I can hear her arm popping and snapping as she moves it over her head. They told her she has calcium deposits in the tendons and that it will go away on its own. But it's been almost a year and she's still suffering. Should she go back and see her doctor?

Yes, most definitely. Calcium deposits in the tendons of the shoulder are referred to as calcific tendinitis. This is a disorder characterized by deposits of hydroxyapatite (a crystalline calcium phosphate).

These deposits can develop in any tendon of the body. The tendons of the rotator cuff surrounding the shoulder are affected most often. The calcific deposits can be seen on X-ray as lumps or cloudy areas. That's how the diagnosis is confirmed.

Pain and inflammation result in loss of motion and function. Sometimes patients report shoulder stiffness or weakness. There may be a snapping or catching sensation during certain shoulder movements. The condition is often self-limiting meaning it goes away or resolves on its own in time (usually six months to a year).

Treatment begins with antiinflammatories, steroid injections, and/or physical therapy. Most patients are encouraged to stick with the treatment plan for six months. If, after six months, the pain isn't reduced enough (or at all), then shock wave therapy called extracorporeal shock wave therapy (ECSW) may be considered. ECSW may be a good next step before thinking about surgery.

If your sister has not had any of these treatment interventions, then that might be the place to begin. But if she has tried all that unsuccessfully for at least three to six months, then surgery may indeed be the next step. Seeing an orthopedic surgeon who can evaluate her shoulder and compare X-rays from a year ago to now will help guide and direct her treatment.

Reference: 

Patrick Vavken, MD, MSc, et al. Focused Extracorporeal Shock Wave Therapy in Calcifying Tendinitis of the Shoulder: A Meta-Analysis. In Sports Health. March/April 2009. Vol. 1. No. 2. Pp. 137-144.

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