Can a calcium deposit burst and what happens during a calcific crisis?

October 2, 2025 •

4 min read

While the name can be misleading, a calcium deposit in a tendon doesn’t truly 'burst' like a balloon, but the body's natural reabsorption process can trigger a sudden and painful inflammatory event known as a calcific crisis. This occurs most commonly in the shoulder and can result in severe, debilitating pain.

Quick Summary

A calcium deposit in a tendon does not burst in the traditional sense. Instead, the body can trigger an acute inflammatory response to reabsorb the mineral, causing significant pain and symptoms referred to as a calcific crisis.

Key Points

The 'Burst' is Inflammation: A calcium deposit doesn't burst like a balloon, but the body's resorption process can trigger a severe, inflammatory reaction known as a calcific crisis.
Intense, Sudden Pain: During this resorptive phase, individuals can experience a sudden and significant increase in pain, warmth, and swelling in the affected area.
Most Common in the Shoulder: Calcific tendinitis, the condition of calcium deposits in tendons, most frequently affects the rotator cuff in the shoulder.
Not Caused by Diet: Increased dietary calcium intake is not linked to the formation of calcium deposits in tendons.
Treatment is Effective: Conservative treatments, shockwave therapy, or percutaneous lavage can effectively manage symptoms and remove the deposit in persistent cases.
Self-Limiting Condition: For many, calcific tendinitis resolves on its own over time as the body naturally reabsorbs the deposit.

Understanding Calcium Deposits

Calcium deposits are a common condition, most frequently occurring in the tendons of the rotator cuff in the shoulder, a condition known as calcific tendinitis. They are a result of calcium phosphate crystals forming within the tendon tissue. Though the exact cause is not always clear, it is often associated with cellular changes within the tendon, not with high calcium intake through diet. These deposits are not always symptomatic, and many individuals may have them without any pain or even knowing they exist. Problems typically arise during the different phases of calcification.

The Phases of Calcific Tendinitis

Calcific tendinitis progresses through several distinct phases, each with its own characteristics and potential symptoms.

Pre-calcific Stage: In this initial stage, the tendon tissue undergoes cellular changes, preparing for calcium deposition. This phase is usually asymptomatic, meaning the patient feels no pain or discomfort.
Calcific Stage: During this stage, calcium is deposited into the tendon. This is further divided into two sub-phases:
- Formative Phase: Calcium is actively deposited, and the deposit is typically firm and has a chalk-like or paste-like consistency. Pain is variable and may be mild or non-existent.
- Resorptive Phase: This is the critical phase where the body begins to reabsorb the calcium deposit. The deposit breaks down, and the consistency can become much softer. This is the stage most people refer to as the deposit 'bursting.' The process triggers a significant inflammatory response, which is the primary cause of intense pain.
Post-calcific Stage: The deposit is completely absorbed, and the tendon tissue begins to remodel and heal. The pain typically resolves as inflammation subsides.

What Happens When a Deposit 'Bursts'?

When a calcium deposit enters the resorptive phase, it doesn't physically explode or burst open like a balloon. Instead, the body's immune system sends cells to break down and clear the calcium particles. This triggers an acute and powerful inflammatory reaction in the surrounding tissue. The intense pain and swelling experienced during this time are the result of this inflammatory process, often referred to as a "calcific crisis".

The Painful Reality of a Calcific Crisis

The pain associated with this inflammatory reaction can be severe and sudden, often starting with little to no warning. It is one of the most intense forms of shoulder pain reported by patients. The area may also become warm to the touch, and swelling can occur, mimicking the symptoms of an infection. This severe pain can limit the range of motion in the affected joint, making even simple movements unbearable.

Diagnosis and Treatment Options

Diagnosing the Problem

A proper diagnosis is crucial to distinguish a calcific crisis from other conditions causing shoulder pain, such as a rotator cuff tear or bursitis. Diagnostic tools typically include:

X-ray: A simple X-ray can clearly show the presence and size of the calcium deposit.
Ultrasound: This can be used to visualize the soft tissue, confirm the location, and assess the nature of the deposit.
Clinical Evaluation: A physical examination and discussion of symptoms with a healthcare professional are essential.

Comparison of Treatment Options


Treatment Method	Description	Best For	Recovery	Effectiveness
Conservative Management	Rest, ice, and non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation.	Mild, less frequent episodes.	2–4 weeks.	Good for pain management, may not speed up resorption.
Corticosteroid Injection	Anti-inflammatory medication injected directly into the affected area.	Acute, severe pain episodes.	Hours to days for relief.	Excellent for quick pain relief, but does not remove the deposit.
Extracorporeal Shockwave Therapy (ESWT)	Non-invasive procedure using shockwaves to break up the calcium deposit.	Deposits resistant to conservative treatment.	Weeks to months.	Good success rate, especially for chronic cases.
Percutaneous Lavage	Ultrasound-guided procedure using needles to break up and aspirate the deposit.	Persistent or painful deposits.	1–3 weeks.	Highly effective for removing deposits.
Arthroscopic Surgery	Minimally invasive surgery to remove the calcium deposit.	Large deposits, failed conservative treatments, or tendon damage.	Months.	Excellent success rate, but is a last resort.

Managing the Pain of a Calcific Crisis

When a calcific crisis occurs, the pain can be overwhelming. Seeking immediate medical attention is advisable. A doctor can help confirm the diagnosis and provide appropriate treatment to manage the pain effectively. While the episode can be short-lived, the goal is to provide relief and support the body's natural healing process. The body will eventually reabsorb the deposit completely, and symptoms will subside.

Long-Term Outlook and Prevention

Most cases of calcific tendinitis, including those with a painful resorptive phase, resolve completely over time. For many, the condition is self-limiting. However, for those with recurrent or persistent symptoms, treatment options like shockwave therapy or lavage can provide a faster and more permanent resolution. While there is no definitive way to prevent calcific tendinitis, maintaining a healthy lifestyle, avoiding repetitive shoulder stress, and managing any underlying conditions can help. It's important to remember that diet is not a significant factor in this process, so changes to calcium intake are generally not recommended. Always consult with a healthcare professional for a personalized treatment plan. Further information on calcific tendinopathy can be found on the National Institutes of Health website.

Conclusion

To answer the question, a calcium deposit does not burst in a literal sense. The term is a layperson's description of a very real and painful medical event: the body's inflammatory response during the reabsorption phase. This process, often called a calcific crisis, can cause intense, sudden pain but is a normal part of the body's healing cycle. With proper diagnosis and management, most individuals can find relief and achieve a full recovery.

Frequently Asked Questions

The resorptive phase, or 'burst,' often feels like a sudden onset of severe, sharp pain in the affected joint, most commonly the shoulder. It may also be accompanied by swelling, warmth, and a restricted range of motion.

The duration of a calcific crisis can vary. While the most severe pain may last for several days, the entire episode can take weeks to months to resolve completely as the body works to reabsorb the calcium.

No, it is not inherently dangerous in the sense of a medical emergency. The event is a natural, albeit painful, part of the body's process. However, the intense pain warrants medical attention to ensure proper diagnosis and management of symptoms.

Extracorporeal Shockwave Therapy (ESWT) is designed to break up and stimulate the reabsorption of calcium deposits, which can mimic or initiate the body's natural resorptive phase. It is a controlled method of encouraging the process that laypeople refer to as 'bursting'.

In many cases, yes. The body's immune system is actively working to reabsorb the calcium, and the process will complete on its own. Medical intervention is primarily used to manage the severe pain and inflammation that accompanies the resorptive phase.

Doctors can treat the pain with anti-inflammatory medications (NSAIDs), local anesthetic injections, or corticosteroid injections to reduce the inflammation. Resting the affected joint and applying ice can also provide significant relief.

There is no guaranteed way to prevent a calcific crisis, as the timing of the resorptive phase is largely unpredictable. For individuals with known deposits, treatments like ESWT may help initiate and manage the resorption process more controllably.