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supraspinatus calcific tendinitis
Hi Mrs B and D- I had mild to moderate shoulder pain on rotation and limited mobility for a week or so . As I have history of frozen shoulder and neck pain the same side, I went to Physio . After the session the pain jumped from 30 to 100 and the doc did ultra sound and X-ray. Attaching it here. I am in lot of pain since Wednesday and it is progressively worsening every day. I literally couldn’t move my left arm and the pain is too bad even without moving. I am given Tylenol 3 ( Acetanamophen / codeine) as I have gastritis and naproxen gives me stomach pain .. however Tylenol or Tylenol 3 or Advil doesn’t do much and already it is lot of medications.Can you please tell me if there is anything else I can do?
I am taking magnesium glycinate 2 tablets , turmeric -2 tabs and drinking green tea.
I am in lot of pain and done know what to do . The only option that ER had was narcotics which I denied.
Please advise.
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3 Replies
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Hey ,
First of all, I hope you’re in not too much pain! Is supraspinatus calcific tendinitis the diagnosis the doctor gave? If so, they have seen calcium deposits on the x-ray. Did your doctors also draw blood? Did they measure for example serum calcium? Vitamin D? And parathyroid hormone? If so, sharing labs will help us in providing you with more detailed advise!
When calcium deposites in soft tissue, finding out why your body is doing this is important. Here are some common root causes:
• Too much calcium in the diet. This might be hard from foods alone, but if you’re using supplements, you might want to check the ingredients list.Some supplements use calcium carbonate as a filler to give supplements the right shape. If you’re using supplements, check the ingredient list as well!
• Not enough vitamin K2. Vitamin K2 is needed to deposit calcium in bones. If you’re looking for a vitamin K2 supplement, look for vitamin K2 mk-4 or vitamin K2 mk-7 on the ingredient list. Which one is better is still being debated.At the moment I would recommend mk-4. Here is a link to the discussion if you’re interested.
• An Overactive thyroid gland can influence calcium in the blood as well. The parathyroid gland (a gland located near the thyroid gland) is involved in serum calcium balance by secreting parathyroid hormone (PTH)This is why you would like to know if your PTH levels are okay.
• Too much vitamin D. If you’re taking high dosages of vitamin D, you’re able to get in calcium more easily. Especially if the balance with vitamin K2 is gone, this can lead to elevated serum calcium levels
• Has your kidney function also been measured? Kidney problems can sometimes cause high calcium.
• Autoimmune disease can also cause elevations in serum calcium.
• Are you using other medications? Some medications can cause higher serum calcium levels as well. If you’re using antacids to reduce stomach acidity, these medications can cause elevations in serum calcium levels (here is the research). Lithium is another example of a medication that can raise serum calcium.
• Some infections can also cause elevated serum calcium levels. It’s good to have that ruled out by your doctor.
• If high levels of calcium run in the family, it’s more likely that there is a genetic component.There are therapies that can help reduce pain with a frozen shoulder. The success of these therapies does depend on the root cause. But before I help you with that, I would like to know what the therapist did that caused the pain to jump from 30 to 100. Here are some questions to guide you:
• Did the pain jump from 30 to 100 in the therapy or after?
• What type of therapy was used? Dry needling? Massage therapy? Something else?
• If massage therapy (or some other manipulation of muscles) was used, did the pain jump immediately after a certain manipulation or did it gradually go up during the therapy?
• If you’re using the muscles, does the pain decrease?
• Is the pain worse when you’ve just woken up?Let us know so when can help you!
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thank you Daniel for the detailed answer.
This was the only imaging done and no other blood work are done., I am seeing my doc tomorrow with these results
1) I am not on much supplements. Was on omega 3
2) I was on pantaparazole for a couple of weeks in June as I had severe acid reflux and then I started Ayurvedic medicines from India and on them for the last 1 month
3) my vit d levels are low and I am not even regular in supplements of vit d . I use vit d+ k2 combo from Atheletic greens
4) the Physio used therapeutic ultra sound , kneading therapy on neck, tens/ ems.
5) I felt very painful during the kneading and it felt a bit uncomfortable after the session . That night there was severe pain while moving arm in sleep.. next two days there was a lot of pain on movement and the range was restricted. Third day couldn’t move one inch any direction and excruciating pain after that5) my last labs were from July and there wasnt much discussed
I am also running mild temp from yesterday like 100-100.5 c . Not sure if it is a separate infection.
Can you please advise me what all blood work should I ask him when I meet tommorrow
Thanks
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Hey ,
In addition to my response yesterday, I forgot to write down that calcium can also be deposited as a result of trauma in the rotator cuff tendon in an attempt to heal the body. You wrote you’ve experienced shoulder and neck problems in the past. Even treatments (like injections) can cause trauma to the area.
If the body is trying to heal from older trauma, then elevations in calcium and hormones that regulate calcium (I’m referring to ParaThryroid Hormone or PTH for short) can be functional.
Here are lab values that I personally would like to know:
To assess calcium balance in the body:
• Serum Calcium
• PTH
• Vitamin DTo assess kidney function:
• eGFR
• Creatinin
• BUNTo assess blood sugar balance:
• Fasting Insulin
• Fasting glucose / HbA1cTo assess inflammation:
• CRP
• Iron and FerritinTo assess Thyroid hormone balance:
• Check out this movie since this topic requires a little more background.To assess immune system function:
• A White Blood cell Count (WBC) including a differentiation of the types of white blood cells. If this is new to you I would recommend the next 2 videos in the newly launched course: this video and this one as well.As a rule of thumb, In functional medicine, we like to know everything because we believe everything in the body is connected.
Tips for treatment
Because I can’t assess exactly what happened during your physiotherapy session, I can’t recommend the type of therapy I usually would recommend. I do recommend discussing with your therapist if strengthening muscles would help.I would also recommend you to follow an anti-inflammatory lifestyle. to support your body.
Minimize sugar, flour products and other foods that spike blood sugar.
Maximize sleep quality and foods that are anti-inflammatory. Fish oil is a good supplement. I usually recommend 2000 to 4000 mg of EPA+DHA per day if inflammation is present. Curcumin and Boswellia are supplements that can with inflammation as well. If you’re low on vitamin D, getting your vitamin D levels up might be helpful as well.
I hope these tips can help you!
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