A friend who is a manic exerciser (swimming, running, aerobics, weights,
etc.) began experiencing pain in her shoulder about a month ago which
has continued and become sharper.  The pain inhibits some movement of
her arm; e.g., she can't bring it up all the way over her head or touch
the middle of her back.  An osteopath, whom she has seen for other
reasons and whom she trusts, first thought it was tendonitis and treated
her with acupuncture.  The acupuncture, besides being painful itself (it
don't matter what anyone says, sticking needles into your body hurts!),
made the shoulder pain worse.  (Or perhaps more accurately, the shoulder
pain got worse after the acupuncture.)

Anyway, the osteopath now believes it's a calcium deposit, and is
discussing treatment first with anti-inflammatory medicine and, if that
doesn't work, with cortisone shots.

My questions are, what's a calcium deposit, what causes it, why does it
hurt, and what makes it go away?  Can anyone out there provide
information?

Many thanks.

Lee Woodbury
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I had a very similar case a year or so back, when I was lifting weights and
playing a LOT of tennis and swimming. It was tendonitis. There are four
tendons attached to the tip of your shoulder that run down and over the
outer shoulder. When one of these gets stressed in some way, tendonitis can
easily result. Your friend is putting a HEAVY load on those tendons.

Let me say first off that I am VERY picky about who I let work on my joints.
Injections, etc. are made into the sac enclosing the joint, and the slightest
infection can result in *amputating* the limb. I've seen it happen. If I saw
the *slightest* indication of less-than-perfect competence on the part of my
osteopath, I'm getting out of there FAST. I don't know exactly what your
friend's osteopath told her, but I find it pretty scary.

First of all, "-itis" means inflammation. Bursitis, appendicitis, et. al.
Such an affliction should be easily visible with X-rays, and the logical
treatment would be anti-inflammatory injection, not "sticking needles in
you."

A calcium deposit is just that. A deposit of calcium (bones are made of
calcium) on a bone surface. If there's a "lump" of calcium in a joint, it
will naturally create painful binding or friction when the joint is moved
a certain way. Don't ask me why he is going to "try" anti-inflammatory
treatment for this. Again, a simple X-ray should disclose something like
this.

I'd tell your friend to find another osteopath before she ends up losing her
arm.

R.A. Morgan

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I thought that kind of thing happened mainly back in the time before anti-
biotics (but that was also the time before cortisone shots, too, wasn't it?).
Is it still common?  It seems to me that getting a cut on one's finger could
also result in losing one's arm, but that the chances would be slim.  What
happens in these cases?  Why do antibiotics fail to work in these cases of
the "slightest infection"?

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The articular surfaces of a joint should be smooth to get good
motion at that joint.  If an infection does settle into a joint,
it can make those surfaces quite rough, causing permanent loss
of some or all freedom of motion.  A classic example is a knuckle
infection after a{*filter*}fight, especially if the knuckles impacted
human teeth (which are about the dirtiest place in the world.)
Fortunately, the body's immune system usually manages to keep
infections from getting rooted in.  This is hampered if the
circulation of fluid through the synovial capsule and back into
the rest of the body is blocked.

Amputations?  Yeyah, they happen.  I have no feeling that they're
common, and no numbers at all.
--

Let me state first off that I'm not an expert in medicine, although I've spent
many years working in hospitals and other medical settings. The above infor-
mation was given to me by two experienced Registered Nurses, both with
Master's degrees.

The "little cut on the finger" is a surface accident. It doesn't approach any
critical tissue areas, and can be easily cleaned and treated. In the case of
a shoulder injection for tendonitis, however, you're talking about infection
starting up 2 or 3 inches beneath the skin, directly *ON* the joint's moving
surfaces, in the immediate vicinity of major CNS objects, bone marrow, etc.
Systemic infection is clearly a possibility, including the lymph apparatus.
If you've ever had this done, you might have noticed (I hope) that before
making the injection, they scrubbed the **** out of your entire shoulder area
with an iodine formula, instead of the usual {*filter*} swab. This is why.

Another reason I was alarmed at the post was that he treated apparent
tendonitis (remember, "-itis" means "inflammation") with acupuncture, with
no results, and then, upon switching to a tentative (sigh) diagnosis of
"calcium deposits," decided to use anti-inflammatory {*filter*} for the CALCIUM
DEPOSITS! Am I in error, or is this physician bananas?

Ron Morgan
Communication Disorders

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