Rheumatology: Current Research
Open Access

Medications and Pain Management in Calcific Tendinitis

Ranjeny Thomas^{* *}Correspondence: Ranjeny Thomas, Department of Rheumatology, University of Sydney, New South Wales, Australia, Email:

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About the Study

Calcific tendinitis is a painful musculoskeletal condition characterized by the accumulation of calcium deposits within tendons, typically in the shoulder. The presence of these calcium deposits can lead to inflammation, pain, and reduced range of motion, significantly impacting the quality of life for affected individuals.

Calcific tendinitis

Before delving into the medications and pain management techniques, it's essential to have a basic understanding of calcific tendinitis. This condition primarily affects the tendons, most commonly in the rotator cuff of the shoulder. The exact cause of calcific tendinitis is not entirely clear, but it is believed to involve a combination of genetic factors, mechanical stress on the tendon, and local inflammation.

The hallmark of calcific tendinitis is the deposition of calcium hydroxyapatite crystals within the affected tendon. These deposits can vary in size and density and are often associated with inflammatory changes in the surrounding tissues. This inflammation contributes significantly to the pain experienced by individuals with calcific tendinitis.

Medications for calcific tendinitis

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs are often among the first medications prescribed for calcific tendinitis. They help reduce pain and inflammation in the affected area. Common NSAIDs include ibuprofen, naproxen, and diclofenac. These medications are available both over-thecounter and in prescription-strength formulations.

Corticosteroids: In some cases, corticosteroid injections may be recommended to provide relief from the pain and inflammation associated with calcific tendinitis. These injections are administered directly into the affected tendon or the bursa surrounding it. Corticosteroids can provide rapid but temporary relief.

Pain relievers: Over-the-counter or prescription pain relievers, such as acetaminophen, can be used to manage pain associated with calcific tendinitis. While they do not directly address the inflammation, they can help improve overall comfort.

Disease-Modifying Anti-Rheumatic Drugs (DMARDs): In cases where calcific tendinitis is linked to an underlying autoimmune or inflammatory condition, such as rheumatoid arthritis, DMARDs like methotrexate may be prescribed to target the underlying disease process and reduce inflammation in the tendons.

Calcium channel blockers: Some studies have explored the use of medications like calcium channel blockers (e.g., nifedipine) to disrupt the formation of calcium deposits in tendons. However, more research is needed to determine their effectiveness for calcific tendinitis.

Pain management strategies for calcific tendinitis

In addition to medications, various pain management strategies can help individuals with calcific tendinitis effectively cope with their symptoms and improve their overall quality of life.

Rest and activity modification: Reducing or modifying activities that exacerbate pain and inflammation is crucial. Resting the affected shoulder and avoiding repetitive overhead movements can help prevent further irritation of the calcific deposits.

Physical therapy: It is a cornerstone of treatment for calcific tendinitis. A skilled physical therapist can develop a customized exercise program to improve range of motion, strengthen the shoulder muscles, and reduce pain. Modalities such as ultrasound and ice may also be used..

Heat and ice therapy: Applying heat or cold packs to the affected area can provide temporary pain relief and reduce inflammation. Heat is typically used before gentle stretching exercises, while ice can be applied after activity to soothe inflammation.

Ultrasound-guided aspiration: In some cases, a healthcare provider may recommend ultrasound-guided needle aspiration to remove the calcium deposits. This procedure can provide immediate relief of symptoms but may require subsequent treatments.

Extracorporeal Shock Wave Therapy (ESWT): ESWT is a noninvasive procedure that uses shock waves to break up calcium deposits in the tendon. It can help alleviate pain and improve function, although multiple sessions may be necessary.

Acupuncture and massage: Some individuals find relief from pain through alternative therapies such as acupuncture or therapeutic massage. These treatments can help relax muscles, reduce tension, and improve circulation in the affected area.

Lifestyle modifications: Maintaining a healthy lifestyle, including proper nutrition and weight management, can have a positive impact on overall joint and tendon health. Smoking cessation is also important, as smoking can impede healing and exacerbate inflammation.

Psychological support: Chronic pain conditions like calcific tendinitis can take a toll on mental health. Psychological support, such as counseling or support groups, can be beneficial in managing the emotional aspects of living with a chronic condition.

Calcific tendinitis can be a challenging and painful condition, but with the right medications and pain management strategies, individuals can experience significant relief from their symptoms. It's essential for individuals with calcific tendinitis to work closely with their healthcare providers to develop a personalized treatment plan that addresses their unique needs and circumstances.