Conditions we diagnose and treat

Calcific Tendinitis of the Shoulder: Treatment in London

Available at LSRI Harley Street (W1G 9QJ) and LSRI Northwest London, Harrow (HA2 7SJ).

Calcific tendinitis of the shoulder happens when deposits of calcium build up within the rotator cuff tendons, most often the supraspinatus tendon at the top of the shoulder.

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GMC / FRCR Dr Prashant Sankaye, Consultant MSK Radiologist

It is most common between middle age and later working life, and slightly more common in women. The cause is not fully understood, and it is not related to how much calcium you eat. Some deposits cause no symptoms at all, while others cause severe pain, particularly when the body starts to break down and reabsorb the calcium. At LSRI, Dr Prashant Sankaye, Consultant MSK Radiologist, uses ultrasound and X-ray to find and assess the calcium and, where it is the right option for you, offers ultrasound-guided treatment including barbotage.

Why choose LSRI

Consultant-led care from Dr Prashant Sankaye, Consultant MSK Radiologist with more than 20 years’ experience.
Diagnosis and ultrasound-guided treatment from the same specialist.
Two clinics: LSRI Harley Street (W1G 9QJ) and LSRI Northwest London in Harrow (HA2 7SJ).
No GP referral needed, and all major insurers accepted.
After Dr Sankaye has reported your scan, you can have a free 5-minute video consultation to go through the results.

Last medically reviewed by Dr Prashant Sankaye, Consultant MSK Radiologist, on 2 October 2026.

Symptoms of calcific tendinitis

Shoulder pain, often at the front or side, sometimes spreading down the upper arm.
Sudden, severe pain that can come on over hours or days, sometimes with no obvious injury.
Pain lifting the arm, especially overhead or out to the side.
Pain at night and difficulty lying on the affected side.
Stiffness and reduced movement because of pain.

If your shoulder is hot, red and swollen and you have a fever or feel unwell, seek urgent medical advice, as this can be a sign of infection.

How we diagnose calcific tendinitis

Diagnosis starts with your history and a shoulder examination. Imaging then confirms the calcium and helps plan treatment.

An X-ray shows calcium deposits clearly and gives a useful baseline to compare with in future.

Ultrasound shows exactly where the calcium sits in the tendon, its size, and whether it looks hard or soft. It also shows inflammation of the bursa above the tendon and the condition of the rest of the rotator cuff. This information helps decide whether barbotage is likely to be suitable. An MRI is not usually needed, but can help if another problem such as a tendon tear is suspected.

What to expect at your appointment

Dr Sankaye reviews your symptoms, how the pain started and any previous X-rays or scans.
He scans your shoulder with ultrasound, and arranges an X-ray or MRI if needed.
He explains the findings, including the size and type of any calcium deposit, and discusses your options.
If you decide to go ahead with an injection or barbotage, it is done under ultrasound guidance.
You receive aftercare advice and a written report, which can be shared with your GP or physiotherapist.

Treatment options

Calcific tendinitis often improves over time, sometimes as the calcium is naturally reabsorbed. Treatment usually starts with:

Pain relief: simple painkillers or anti-inflammatory medicines if they are suitable for you.
Activity changes: avoiding the movements that trigger pain while it is severe.
Physiotherapy: to maintain movement and strengthen the shoulder as the pain settles.

If pain is severe or does not settle, the options at LSRI include:

Ultrasound-guided steroid injection: an injection into the bursa above the rotator cuff can reduce inflammation and ease pain, usually in the short term.
Barbotage: under ultrasound guidance, a needle is used to break up the calcium deposit and rinse some of it out with sterile fluid. It is usually combined with a steroid injection into the bursa and is done under local anaesthetic. It can be helpful for suitable deposits, particularly softer ones, and some people need more than one treatment. You can read more on our tendon procedures page.
MSK specialist consultation: a detailed review of your symptoms, scans and previous treatment, with a clear plan.

Shockwave therapy is another non-surgical treatment used for calcific tendinitis, offered by some physiotherapy and sports medicine clinics. Dr Sankaye can advise whether it may be worth considering.

Surgery to remove the calcium is rarely needed. Dr Sankaye can advise when a shoulder surgeon’s opinion is worthwhile, for example if pain persists despite other treatments.

Questions about calcific tendinitis

Is calcific tendinitis caused by too much calcium in my diet?

No. The calcium deposits are not linked to diet or calcium supplements, and you do not need to change what you eat.

What does barbotage feel like?

Local anaesthetic is used, so most people feel pressure rather than sharp pain during the procedure. The shoulder can be sore for a few days afterwards, and we will give you advice on pain relief and activity.

Will the calcium come back?

Deposits can sometimes return or form in a different place, but for many people symptoms settle once the calcium has been reabsorbed or treated.

Can calcific tendinitis get better on its own?

Yes. The body can reabsorb the calcium naturally over time. This phase can be very painful, but it is often followed by improvement. Treatment aims to ease pain and help this process where needed.

Our clinics

Two clinics, one team

Dr Prashant Sankaye, Consultant MSK Radiologist, sees patients at Harley Street in central London and at our Northwest London clinic in Harrow. Call one number to book at either clinic.