Calcific shoulder: calcium deposits in the shoulder tendons

Clinicians call the condition chronic calcific tendinopathy or peritendinitis calcarea. It means calcium deposits in the tendons of the rotator cuff, the tendons that hold the head of the upper arm in place in the shoulder joint [1][2]. NHI uses the term calcium deposit rather than calcific shoulder [2].

The calcium can be shown on X-ray or MRI [2]. That it is present does not always mean that it causes symptoms, since it is also seen in people without symptoms [3].

NHI discusses calcium deposits in its article on tendinopathy of the shoulder. It describes shoulder pain that gets worse with particular movements, and reduced function. With problems in the most commonly affected tendon, supraspinatus, lifting the arm out to the side is especially painful [2].

The sources used here do not give a separate description of how the pain presents with calcium deposits compared with other tendon conditions in the shoulder.

The diagnosis in tendinopathy of the shoulder is often made from the history and a clinical examination of mobility [2]. Calcium deposits can be shown on X-ray or MRI [2]. Imaging findings must be interpreted together with the symptoms, since calcium is also found in people without problems [3].

NHI describes exercise and activity adjustment as the first choice in tendinopathy of the shoulder. You should avoid movements that trigger pain, but not keep the arm still, since the shoulder can then become stiff. Rehabilitation is gradual, with stretching and eventually strength training, and can be guided by a physiotherapist [2].

Shockwave therapy can be used as an addition to exercises when there are calcium deposits, but is not recommended without calcium [2]. NHI writes that there are no clear guidelines for the best treatment of calcium deposits [2].

A network meta-analysis of 14 randomised trials with a total of 1105 patients compared non-surgical treatments. Ultrasound-guided needling and two forms of shockwave therapy relieved pain and could also lead to the calcium dissolving. The authors nevertheless conclude that it is unclear which is best [1].

Removal of calcium, often ultrasound-guided lavage, has been regarded as treatment aimed at the cause itself. The method had only been compared with other methods in cohort studies [3].

A randomised, double-blind study from Norwegian and Swedish hospitals included 220 patients in three groups. After six weeks the groups that received injection were slightly better than the group without. After four months there was no difference in pain or function between the groups. Within two years half of the patients in all groups needed additional treatment. All three groups were better than at baseline [3].

The authors believe that patients should be told that most improve without the calcium being removed, and that pain relief combined with physiotherapy is sufficient for most [3]. This is a summary in Tidsskriftet of a study published in BMJ in 2023, and the assessment comes from the researchers.

The sources do not give a specific time course for calcific shoulder. In the Norwegian study all three groups were better than at baseline after two years, but half needed additional treatment along the way [3]. NHI writes that repeated or inadequately treated tendinopathy can lead to long-lasting problems [2].

The sources have no separate overview of warning signs in calcific shoulder. NHI mentions that a doctor can make the diagnosis and consider further treatment, for example injection or sick leave in work-related problems [2]. If the shoulder pain is severe, persists or gets worse, there is reason to have it assessed.

A physiotherapist can examine the shoulder, go through what triggers the pain and plan gradual rehabilitation. When the diagnosis is uncertain, diagnostic ultrasound can be used as a supplement to the examination. You can also read about shockwave therapy and about shoulder pain from the rotator cuff.

What is calcific shoulder?

Calcific shoulder is an everyday name for calcium deposits in the shoulder tendons, especially in the rotator cuff. Clinicians call it calcific tendinopathy [1][2].

Does the calcium have to be removed?

The authors of a Norwegian study believe that most people improve without the calcium being removed, and that pain relief combined with physiotherapy is sufficient for most [3]. The individual assessment is made together with a doctor or physiotherapist.

Can you have calcium in the shoulder without pain?

Yes. Calcium deposits are also found in people without symptoms [3].

Does shockwave therapy help in calcific shoulder?

NHI writes that shockwave therapy can be an addition to exercises when calcium is present [2]. In a pooled review some forms relieved pain, but it is unclear which is best [1].

The page about supraspinatus tendinitis describes tendinopathy in the tendon most often involved. The article on frozen shoulder covers a different shoulder condition. You can find more articles in the overview of articles.

This article was written by Dr.Dropin Fysikalske and is based on the sources listed below. It gives general information and does not replace an examination by a healthcare professional.

The websites were accessed and read on 22 October 2026.

1. Kalkutfellinger i rotatorcuffen (Calcium deposits in the rotator cuff). NHI.no, Fra vitenskapen (summary of Wu YC et al., Arch Phys Med Rehabil 2017;98(8):1678-1692). 23 August 2017. Link

2. Senebetennelse i skulder (Tendinopathy of the shoulder). NHI.no, based on Legehåndboka. Last updated 15 October 2024. Link

3. Sørensen SM. Skylling av kalkskulder bør revurderes (Lavage of calcific shoulder should be reconsidered; summary of Moosmayer et al., BMJ 2023). Tidsskr Nor Legeforen, 26 February 2024. Link