What Causes Calcium Build Up In Your Body – Origin and natural history of calcium deposits. The rotator cuff is a group of four muscles located in the shoulder that are involved in lifting and rotating the arm laterally. These muscles are attached to the humerus by tendons, in which one or more calcium deposits can be found. This is known as calcific tendinitis of the rotator cuff. Calcific tendinitis is a common pathology affecting approximately 5% of the general population, but the origin of the calcium deposits is unknown. It has been suggested that this is due to abnormal healing of the damaged tendon as a result of microtrauma, but the absence of a dominant side is inconsistent with a mechanical cause. Today, spontaneous transformation of tendon structure and genetic causes is actually recommended.

The structure of the tendon changes around the calcium deposit, causing calcification that increases in size until it stabilizes. This phase is generally asymptomatic.

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The calcium deposits are very hard during this phase and the tendon pain often experienced is related to the hyperpressure created by the calcium deposits inside the tendon. Due to the increase in size, the tendon can also catch on the acromion, the bony arch that extends over the rotator cuff tendons, when moving the arm. This is known as subacromial impingement.

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In the resorption phase, the hard calcium deposit softens. The volume and tension of calcium deposits increase, signs of inflammation appear, and pain is mainly caused by inflammation of the subacromial bursa due to the released calcium microcrystals. In this phase, the pain is intense, causing insomnia and it is impossible to actively move the arm.

In the resorption phase, calcium deposits first become more transparent, then the edges become cloudy and heterogeneous.

Progression towards spontaneous resorption (a new x-ray after a few months shows that the calcium deposit has completely resorbed)

Calcium deposition naturally proceeds through various stages until it is spontaneously resorbed. Healing can cause episodes of pain, sometimes intense.

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It may take a few months to several years for the calcium deposits and symptoms to disappear. It is unpredictable.

Sometimes the progression stops in the calcification phase (persistent type A or B) or the resorption phase (persistent type C) and the pain persists.

X-rays are the best way to evaluate calcific tendinitis of the rotator cuff. The location and phase of calcification can be determined. It involves the supraspinatus tendon in 80% of cases, the infraspinatus tendon in 15% of cases, and the subspinatus tendon in 5% of cases.

X-ray-guided injections of corticosteroids into the subacromial space may be beneficial, especially in the resorptive phase (type C) when there is significant inflammation of the subacromial bursa.

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These are ideally high-energy focused acoustic waves delivered by a machine on the surface of the skin over the diseased tendon with the aim of loosening the calcium attached to the tendon in order to remove it.

Shockwaves are preferably indicated in the calcification stage, when the calcium deposit is hard. Three sessions are recommended and the effectiveness of this treatment varies from 10 to 70% depending on the studies.

Irrigation and aspiration are ultrasound or X-ray guided. This treatment is often combined with the injection of corticosteroids into the calcium deposit and is only possible if the calcium has softened (type C).

Arthroscopic surgical treatment consists of removing the calcification and potentially providing more room for the tendon by increasing the subacromial space. This is achieved with acromioplasty.

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In advance, it must be ensured that the calcification does not resorb spontaneously, which can trigger or increase pain and lead the patient to consult a surgeon. In this situation, surgery would be pointless and therefore it is important to take 2 x-rays at least 3 months apart that show no changes in the appearance of the calcification.

Finally, one must ensure that the shoulder is not rigid before surgery, as this suggests adhesive capsulitis secondary to calcaneal tendinitis, in which surgery is contraindicated. In this case, rehabilitation with balneotherapy is preferred to restore joint mobility.

The operation is planned during pre-operative consultations. To minimize the risk of complications, a pre-anesthesia consultation and, if possible, a pre-operative evaluation are carried out before the operation. This procedure is usually performed under general anesthesia. The anesthesiologist decides the most suitable anesthetic together with the patient.

The operation is performed in the operating theater according to strict cleanliness and safety standards. The patient is placed in a beach chair or side-lying position and a light traction force is applied to the arm.

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The procedure is performed arthroscopically, using a minimally invasive surgical technique. Very small incisions of a few millimeters are made in the skin, through which the camera and instruments necessary for the operation can be inserted into the shoulder. Arthroscopic surgery allows assessment of damage and planned procedures while minimizing trauma and unsightly appearance (small scars) to the shoulder.

This is the first stage of the operation and involves the removal of the subacromial bursa, which contains calcium microcrystals and is therefore often very inflamed and painful.

Because the calcification is inside the tendon, it cannot be seen and must be localized. If it is very large, it can be easily localized because it deforms the tendon. In other cases, the tendon is not deformed and is examined with a hollow needle. The location of the calcification is confirmed by occlusion of the needle point with calcium deposits and/or calcium fragments where the tendon was perforated by the needle.

If calcification is found, the tendon is cut longitudinally to remove the calcification, which is aspirated with special instruments. After removal, the tendon is left as is and heals spontaneously.

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In rare cases, especially in type C calcifications, calcification is not detected and thus acromioplasty is performed.

This involves thinning of the acromion, the bone under which the affected tendons slide. Acromioplasty is not performed systematically. This is done for type C calcification, removal of calcium deposits, or pathologic aspects of the superficial aspects of the rotator cuff tendons.

A rotator cuff tendon tear is rarely discovered during surgery where the calcification is, but if it is, the tendon is repaired.

Postoperative pain is managed by anesthesiologists, who often use an interscalene nerve block that numbs the shoulder and upper extremity several hours after the patient wakes up.

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The shoulder does not need to be immobilized, but the arm will be placed in a sling for the first few days to reduce postoperative pain.

Mobilization should start early. Self-rehabilitation exercises are explained by physiotherapists during the stay at the clinic, and more intensive rehabilitation begins with a local physiotherapist. Rehabilitation often lasts 1-2 months.

Follow-up consultations are planned 1 and 3 months after the operation to ensure a good recovery and to adjust the rehabilitation, as well as to detect possible complications. During these consultations, the progressive disappearance of the calcification is checked using X-rays.

From a practical point of view, medical leave is often 3-6 weeks, but depends on the patient’s profession and the operated side (dominant or not). Driving can be resumed approximately 3 weeks after the operation and sports can be resumed from the 3rd month after the operation.

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Unfortunately, there is no such thing as zero risk in surgery. Each surgery has its own risks and limitations that you must agree to or not undergo surgery. However, if surgery is proposed, the surgeon and anesthesiologist will consider that the expected benefit far outweighs the associated risk.

Some risks, such as microbial surgical site infections, are common to all types of surgery. Fortunately, this complication is rare, but when it occurs, it requires another operation and a course of antibiotics. Bruising may also occur around the surgical site.

In rare cases, the shoulder may remain stiff and painful for several months after surgery. This complication, called capsulitis, is associated with an unpredictable response of the sympathetic nervous system and takes a long time.

Nerves can also be accidentally damaged during surgery, with the risk of paralysis or loss of sensation in the operated limb, which can be temporary or permanent.

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If you have any concerns about surgery, don’t hesitate to talk to your surgeon or anesthetist and they will answer any questions you may have. Medically Reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — By Marjorie Hecht — Updated June 26, 2018

Current treatments can help treat calcium salt build-up and bumps under the skin. New treatments are being developed. It is best to consult a doctor for all symptoms and treatment.

Calcinosis cutis is the accumulation of calcium salt crystals in your skin. Calcium deposits are hard lumps that do not dissolve. The shape and size of the damage are different.

This is a rare condition with many different causes. These range from infections and injuries to systemic diseases such as kidney failure.

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Often calcinosis cutis

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