Sudden shoulder pain
Pain can intensify without any injury, and may be present even when the arm is still.
SHOULDER PAIN GUIDE
Calcific tendinitis
of the shoulder.
Calcium deposits in a rotator cuff tendon can cause pain and restrict movement. A deposit on an image is not by itself a reason to treat — the symptoms and the examination decide that.
SYMPTOMS
What it can feel like
The pattern differs between people. It can arrive suddenly and severely, or sit in the background as stiffness and restricted movement.
Pain that worsens at night
Lying down, or rolling onto the affected side, often makes it more uncomfortable.
Restricted movement
Lifting the arm or reaching behind the back becomes difficult, and range of motion narrows.
DIAGNOSIS
Is the deposit the cause?
Not always. Shoulder pain also comes from rotator cuff tears, bursitis and frozen shoulder. What matters is whether the deposit and your current symptoms are connected — which is a judgement made at examination, not from the image alone.
Examination
Which movements reproduce the pain, how far the range of motion extends, and whether strength has changed.
Imaging
X-ray and ultrasound help show where the deposit sits and the state of the surrounding tendon and bursa.
Further assessment
Considered where there was trauma, where weakness is marked, or where another condition is suspected.
TREATMENT
Non-surgical options
Treatment is chosen from the intensity of pain, the limitation of movement, the deposit itself and how earlier treatment went. Options are combined or staged rather than applied uniformly.
- Activity and medication — adjusting what aggravates it, with anti-inflammatory medication where appropriate
- Exercise and rehabilitation — restoring movement within a pain-controlled range
- Injection — considered where inflammation of the surrounding bursa is part of the picture
- Shockwave therapy — one of the non-surgical options; see shockwave therapy
- Referral — where symptoms persist, ultrasound-guided lavage or surgical assessment at a larger hospital may be discussed
The size of a deposit on an image does not by itself decide the treatment. Current pain, functional limitation and examination findings are weighed together.
FAQ
Common questions
Does a calcium deposit always have to be treated?
No. If a deposit is visible on imaging but you have little or no symptom, treatment may not be needed. What matters is whether your pain and loss of function relate to that deposit.
Why is the pain worse at night?
When inflammation and irritation of the surrounding tissue are at their most active, pain can appear at rest, including at night. Other shoulder conditions also cause night pain, so it needs examining.
Will shockwave therapy dissolve the deposit immediately?
Response varies between people, and no one can promise that a single session removes a deposit. Pain, function and imaging are reviewed together to judge the response.
Injection or shockwave — which is better?
Neither is better for everyone. The choice depends on the pain pattern, the inflammation around it, the state of the deposit and how you responded to earlier treatment.
Do I need an MRI?
Not in every case. It is considered where a rotator cuff tear or another condition is suspected, or where the examination calls for further assessment.
Medically reviewed by
Eugene Jung, MD · Specialist in Anaesthesiology and Pain Medicine · Seoul National University College of Medicine
Last updated: September 2026
Eugene Jung, MD · Specialist in Anaesthesiology and Pain Medicine · Seoul National University College of Medicine
Last updated: September 2026
APPOINTMENT
Shoulder pain that
will not settle?
Tell us when it started, which movements hurt and whether it wakes you at night.
We reply within 24 hours during clinic hours. Prefer email? nasolpain@gmail.com