®Pendulum
Lean forwards, resting your good hand on a table. Let your painful arm hang loosely and gently sway your body so the arm makes small circles. Don’t use your muscles to force the arm.
1–2 minutes in total, 4–5 times a dayAges 30–60When it is most common; slightly more common in women
A few weeksHow long it often takes for the severe pain to settle
9 monthsIt can take this long, or longer, for the calcium to dissolve completely
8%Approximate share of adults without symptoms who also have calcium deposits
Symptoms
- Shoulder pain and stiffness that come on suddenly.
- Intense pain when you move your arm.
- Severe pain that disturbs your sleep.
- Reduced shoulder movement, tenderness over the shoulder tendons.
What causes it?
- Calcium builds up in the tendons around the shoulder (the rotator cuff) and irritates the tendon.
- The most severe pain often comes when the body starts to reabsorb the calcium.
- Calcium is not always painful; an examination shows whether calcium seen on an X-ray is linked to the pain.
What helps?
1
Control the pain
You can take painkillers or anti-inflammatory medicines after checking with your doctor or pharmacist. Ice packs can also ease the pain.
2
Reduce the load
Take things a little easier for the first few weeks and change activities that make the pain worse.
3
Keep the arm moving
Move your shoulder as far as the pain allows; this prevents stiffness. Use a sling only briefly, for comfort.
4
Build up step by step
Once the severe pain has settled, move on to stretching and strengthening exercises. If symptoms persist, physiotherapy can help.
Exercises at home
Six exercises to free up the shoulder step by step
Start with the first three exercises. As the pain begins to ease, usually after 2–3 weeks, add the others. Move within your natural range without forcing; the exercises should not increase your symptoms.
Upright posture
Sit or stand tall. Without lifting your shoulders, draw them back and slightly down so your chest opens.
Hold for 20–30 seconds, 5 repetitionsBending and straightening the elbow
Let your arm rest comfortably by your side. Bend your elbow fully within a pain-free range, then straighten it fully. A gentle stretch is enough; don’t push into pain.
10–15 repetitions, 4–5 times a daySliding the arm up the wall
Stand facing a wall and rest the forearm of your painful arm against it. Slide your arm up the wall within a pain-free range, then slowly lower it.
10 repetitions, 4–5 times a day (after the first 2–3 weeks)External rotation with a stick
Keep the elbow of your painful arm tucked into your side and bent to 90 degrees. Hold a stick in both hands; push with your good arm to slowly move the forearm of your painful arm outwards.
Hold for 5 seconds, 10 repetitions (after the first 2–3 weeks)Pushing outwards against a door frame
Keep your elbow bent to 90 degrees and close to your body. Rest the back of your hand against a door frame and gently push outwards without moving your arm.
5 seconds, 10 repetitions (once the pain has eased)Frequently asked questions
An X-ray showed calcium; is that the cause of my pain?
Not always. Calcium deposits in the shoulder tendons are also found in about 8% of adults without any symptoms. So calcium on an X-ray does not by itself show what is causing the pain; it needs to be assessed together with an examination.
Does the calcium go away on its own?
Most calcium deposits disappear on their own over time. The severe pain often settles within a few weeks, but it can take 9 months or longer for the calcium to dissolve completely, and milder pain may continue during this time.
Why did the pain suddenly become so severe?
Sudden, very severe pain often comes when the body starts to reabsorb the calcium. So however hard this phase is, it is often part of healing.
What treatments are available?
The first step is controlling the pain and keeping the arm moving as far as the pain allows. If the pain does not settle, your doctor may suggest a steroid injection, breaking up and washing out the calcium with a needle under ultrasound guidance (lavage), or shockwave therapy. A review found that lavage may be more effective than shockwave therapy or a steroid injection alone, but the quality of the evidence is low. Surgery is kept for the rare cases where pain cannot be controlled in other ways.
Should I use a sling?
Use a sling only briefly, for comfort, and stop as soon as you can. Moving your shoulder without increasing the pain prevents stiffness. Sleeping propped up on pillows may be more comfortable.
For pain that increases when you lift your arm out to the side, see the shoulder impingement guide; for gradually increasing stiffness, see the frozen shoulder guide.
When should you see a doctor?
- Sudden or very severe shoulder pain, or you cannot move your arm at all
- The pain started after an injury or a fall
- Your shoulder has changed shape or is badly swollen
- Pins and needles that don’t go away, or loss of feeling in your arm
- Your shoulder feels hot or cold to the touch, or you have a fever or feel unwell
- The pain is getting worse or has not improved within 2 weeks
Sources
- NHS Lothian. Calcific tendinopathy. Patient information, July 2020.
- Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust. Shoulder calcific tendonitis. WPR45490, 2017.
- Whittington Health NHS Trust. Calcific tendinopathy. 2025.
- Lafrance S, Doiron-Cadrin P, Saulnier M, et al. Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials. BMJ Open Sport Exerc Med. 2019;5(1):e000506.
- NHS. Shoulder pain.