If you've ever experienced persistent shoulder pain that affects your daily activities, you know just how frustrating it can be. One common yet often misunderstood cause of shoulder pain is calcific tendinopathy of the rotator cuff. This condition can make simple movements, like lifting your arm, feel nearly impossible due to pain and subsequent limitation of movement. Fortunately, there's an effective treatment called barbotage needling, which can help relieve your discomfort and restore your range of motion.
In this blog by ACTIVATE Musculoskeletal Clinic, we'll cover what calcific tendinopathy is, why it happens, its symptoms, how it's diagnosed, and how barbotage needling can help.
Understanding Calcific Tendinopathy of the Rotator Cuff
The rotator cuff is a group of muscles and tendons in your shoulder that help stabilise and mobilise the joint. In calcific tendinopathy, calcium deposits build up in these tendons, leading to inflammation, pain, and difficulty moving your shoulder.
The calcium deposits often occur in the Supraspinatus tendon, which is part of the rotator cuff and helps lift the arm from the side (Abduction).
What Causes Calcific Tendinopathy?
While many people think of calcific tendinopathy as a sports-related condition, it can affect anyone, including those who aren’t particularly active. People aged between 30 and 60 are most commonly affected, and women may be slightly more prone to the condition than men. While the exact cause of these deposits is not fully understood, several factors are thought to contribute:The exact cause of calcific supraspinatus tendinitis is unknown, but some risk factors include:
Repetitive overhead movements: Activities like tennis, swimming, or baseball involve these motionsÂ
Shoulder injuries: Previous shoulder injuries can increase the likelihood of calcific supraspinatus tendinitis and subsequent tendinopathyÂ
Blood supply and ageing of the tendon: Delayed healing is a key issue. Tendons heal through fibroblasts, which are eventually replaced by osteoblasts that promote bone growth in the tendon. Delayed healing can result in calcific deposits.
Symptoms of Rotator Cuff Calcific Tendinopathy
The symptoms can range from mild discomfort to severe, debilitating pain. Common symptoms include:
Intense Shoulder Pain: Pain can be constant or intermittent, often worsening at night.
Limited Range of Motion: Difficulty lifting the arm or rotating the shoulder.
Tenderness: The shoulder may feel tender to the touch, especially at tendon bone insertion area.
Pain with Certain Activities: Activities such as reaching overhead or behind your back can become particularly painful.
Sometimes, people experience episodes of acute pain when the body attempts to reabsorb the calcium deposit. This can cause severe inflammation and swelling, making even the smallest movements excruciating.
If these symptoms sound familiar, it might be time to take action. Book an appointment now at ACTIVATE Musculoskeletal Clinic for a thorough shoulder assessment and personalised treatment. Click here to schedule your visit.
Diagnosing Calcific Tendinopathy
If you visit our clinic with symptoms of shoulder pain, the first step is an in-depth assessment. Diagnosing calcific tendinopathy typically involves:
Physical Examination: Your doctor will assess the movement of your shoulder, look for tenderness, and evaluate your range of motion, including performing specific clinical tests.
Imaging Studies: Ultrasound plays a crucial role in diagnosing and evaluating the exact size and location of the calcium deposits from the early stages, assessing the condition of the tendons, and guiding precise treatment interventions like barbotage needling. Learn more about our ultrasound services here. An X-ray can also help visualising the calcium deposits in the tendon, usually in late stages.
Once a diagnosis is made, we can move forward with the best treatment plan tailored to your needs.
Treatment Options for Calcific Tendinopathy
Treatment depends on the severity of your symptoms and how much the calcium deposits are affecting your quality of life. Here are some of the most common treatment options:
Conservative Management
For many people, treatment begins with non-invasive management to reduce pain and inflammation. This may include:
Physiotherapy: Specific exercises to improve shoulder mobility and strength.
Anti-Inflammatory Medications: To reduce pain and inflammation.
Steroid Injections: Corticosteroid injections are given to relieve severe pain.
However, if these methods fail to improve symptoms, or if the calcium deposits are causing significant discomfort, more targeted intervention may be needed. One such effective procedure is barbotage needling.
Barbotage Needling for Calcific Tendinopathy
Barbotage needling, also known as ultrasound-guided Barbotage procedure, is a minimally invasive treatment designed to break down and remove calcium deposits from the rotator cuff tendon. Here’s how it works:
Ultrasound guidance: The procedure is performed under ultrasound guidance to ensure precision.
Needling the deposit: Local anaesthetic is injected for pain relief during the procedure and a fine needle is used to puncture the calcium deposit, breaking it into smaller fragments.
Flushing Out the Calcium: A saline solution is then injected to help flush out the calcium fragments from the tendon.
Barbotage is often combined with a corticosteroid injection to reduce inflammation after the procedure. Patients typically experience significant pain relief and improved function within weeks of the treatment.
This procedure is usually done in an outpatient setting by an experienced doctor in clinic. Most people can resume light activities the next day and experience substantial pain relief in the weeks following the procedure.
Find out if barbotage needling is right for you. Book your consultation at ACTIVATE Musculoskeletal Clinic today to learn more about your options for effective shoulder pain relief. Visit mskclinic.co.uk/book-online to schedule an appointment.
Benefits of Barbotage Needling
Barbotage needling is particularly beneficial for individuals who have not experienced relief from conservative treatments. Here are some of the key benefits:
Minimally Invasive: Unlike surgery, barbotage does not require large incisions or prolonged recovery periods.
High Success Rate: Many patients experience significant pain relief and improved mobility after the procedure. (see references below)
Quick Recovery: You can return to light activities the day after the procedure and gradually resume their normal activities.
Recovery After Barbotage Needling
After the procedure, you may experience some soreness in your shoulder, which can last for a few days. Your doctor will recommend a physiotherapy programme to help restore your shoulder’s range of motion and strengthen the surrounding muscles. Full recovery typically takes several weeks, but many patients notice pain relief and improved mobility sooner.
It's crucial to follow guidance on post-procedure exercises to ensure the best possible outcome.
Is Barbotage Needling Right for You?
If you’ve been dealing with shoulder pain due to calcific tendinopathy and conservative treatments haven’t provided relief, barbotage could be the solution. The best way to determine whether you’re a candidate for barbotage needling is to get the right clinical and imaging assessment.
At ACTIVATE Musculoskeletal Clinic, we offer one-stop shoulder pain assessment and treatment services to help you understand your condition and find the most effective path to recovery. Book your appointment now at ACTIVATE Musculoskeletal Clinic for a personalised assessment and treatment. Click here to get started.
Conclusion
Calcific tendinopathy of the rotator cuff can be a painful and frustrating condition, but you don’t have to live with it forever. Barbotage needling is a highly effective, minimally invasive treatment that can help break down calcium deposits and restore your shoulder’s function, getting you back to the activities you enjoy.
Contact ACTIVATE Musculoskeletal Clinic today for a comprehensive evaluation and treatment plan tailored to you. Visit mskclinic.co.uk/book-online to schedule your consultation and start your journey towards a pain-free life.
About the Author:Â Dr. Mustafa Alnaib MBChB, MRCS, MSc, FEBOT is an orthopaedic surgeon, musculoskeletal doctor and Clinic Director at ACTIVATE Musculoskeletal Clinic in Kent.
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