Calcium in more than your bones

Calcium is the most abundant mineral in your body and is always present in your bloodstream. It’s crucial for the health of your muscles, nervous system, blood circulation, and digestion. But unwanted calcium deposits in soft tissues can be painful and may be a sign of an underlying condition.

Some people try changes in diet or lifestyle to treat their symptoms. Others try supplements that they hope will directly dissolve the calcium deposits. There are very few studies supporting the effectiveness of supplements.

To help you make your own choices, keep reading to find out about the common types of calcium deposits in your body and their potential treatments.

Achilles tendon ossification (ATO) is a rare condition in which calcium builds up in the tendon that attaches your heel to your lower leg. Pain and swelling in the heel and the ankle joint are the main symptoms, along with a bulge near the heel. It may occur on one or both sides.

Although the cause of ATO is unknown, trauma resulting from surgery or injury can be a major contributing factor. Systemic diseases, metabolic syndrome, and infection may also contribute. One case report suggests there may be a hereditary link.

ATO treatments

If pain is severe or if there’s a fracture in the tendon, your doctor may recommend surgery.

The aim of surgery for ATO is to remove the portion of the tendon where the calcium buildup (ossification) has taken place, while preserving its function. This may require reconstruction of the tendon.

A recent report describes one case where dermal regenerative matrix, a material made for tissue healing, was used to help regrowth of a person’s Achilles tendon. After the procedure, that person wore a cast around their foot and ankle for six weeks, with changes every two weeks.

They were then allowed to use a lower leg walker to partially bear weight on their leg. Within 14 weeks, they were back to walking without the help of a walker.

Calcinosis cutis is the deposit of calcium under the skin.This can happen anywhere on the body. One rare form of it can occur on the face or upper body after a case of acne.

The deposits usually show up as whitish bumps on the skin’s surface. They may have no other symptoms, or they may become tender and discharge a chalk-colored creamy material that’s mainly calcium.

Causes of calcinosis cutis

The causes of calcinosis cutis are broken down into four major types:

  • Dystrophic calcinosis cutis refers to calcium deposits that result from trauma, acne, varicose veins, infections, and connective tissue disease.
  • Metastatic calcinosis cutis can be caused by hyperactive thyroid, an internal cancer, destructive bone disease, excessive vitamin D intake, sarcoidosis, and chronic renal failure.
  • Iatrogenic calcinosis is the name for calcium deposits that result from a medical procedure such as calcium injections or repeated heel sticks (pricking the heel to draw blood) with newborns.
  • Idiopathic calcinosis is the name given when there’s no known cause for the condition. It’s usually localized in one area.

Calcinosis cutis treatments

The treatment of calcinosis cutis depends on identifying the underlying cause. Once the underlying cause is addressed, your doctor may use medications to help relieve the symptoms. These can include corticosteroids (cortisone), magnesium supplements, and aluminum antacids, although these are generally of limited benefit.

Your doctor may recommend surgical removal of the calcinosis if it repeatedly becomes infected, is very painful, or restricts motion.

Your doctor may refer you to other specialists, including a nephrologist (kidney specialist), rheumatologist (musculoskeletal specialist), or hematologist (blood specialist).

Find out more about conventional and alternative treatments for calcinosis cutis.

Diagnosing calcinosis cutis

As calcinosis cutis is usually a symptom of some other condition, your doctor will take your medical history and perform tests to try to determine what that is. They’ll send blood samples to a laboratory for tests that can discover abnormalities in your metabolism that might be producing the excess calcium.

Your doctor may perform a biopsy to confirm the diagnosis of calcinosis cutis. In a biopsy, they’ll administer an anesthetic and then remove a small portion of skin and the tissue below it.

In the rare case that the calcium deposit is in the face, your doctor will try to determine if you previously had acne.

If acne scars are visible, your doctor may perform a punch biopsy to examine skin below the surface layer for the presence of calcium. One reason for the test is to rule out connective tissue disease, which is more serious than a calcium deposit.

A punch biopsy is done in a doctor’s office or clinic using a small metal tube with sharpened edges. After the area is anesthetized and frozen to eliminate pain, your doctor will use the tube to remove the lower layers of skin tissue. In some cases, one or two stitches are needed to close the wound. The procedure takes 15 minutes.

Calcific tendonitis is the unwanted buildup of calcium deposits in your muscles or tendons. Although this can happen anywhere in the body, it’s most common in the rotator cuff of your shoulder. This condition may also be described as calcium deposits in the shoulder.

Calcific tendonitis symptoms

The main symptom is severe, sometimes disabling, pain. It can occur without any apparent cause, especially in the morning. It may be accompanied by stiffness and a frozen shoulder.

Among the possible causes of this condition are genetic predisposition, abnormal thyroid activity, and diabetes.

Calcific tendonitis treatments

Most cases of calcific tendonitis can be treated without surgery. Your doctor may recommend a course of physical therapy and over-the-counter (OTC) pain relievers. If the pain and swelling are more severe, they may suggest that you have a corticosteroid (cortisone) injection given in the office.

Other nonsurgical procedures include:

  • Extracorporeal shock wave therapy (EWST). Your doctor uses a handheld device to deliver small mechanical shocks to your shoulder. This treatment may be repeated once a week for three weeks.
  • Radial shock wave therapy (RSWT). This is similar to EWST. Your doctor uses a handheld device to deliver medium-energy mechanical shocks.
  • Therapeutic ultrasound. Your doctor uses a small device to direct a high-frequency sound wave to help break up the calcium deposit in your shoulder.
  • Percutaneous needling. After you have local anesthesia, your doctor uses a needle guided by ultrasound to manually remove the calcium deposit from under your skin.

If surgery is needed, there are two choices:

  • In open surgery, your doctor uses a scalpel to manually remove the calcium deposit in the shoulder.
  • In arthroscopic surgery, your doctor makes a tiny incision and inserts a camera. The camera helps to guide a small surgical tool to remove the deposit.

Recovery depends on the size and number of calcium deposits. Some people return to normal motion within a week. Others may experience postsurgical pain for some time.

Breast calcifications are found in about 50 percent of women over age 50 and in 10 percent of younger women according to Harvard Medical School. Most of these are benign, but they may occur together with breast cancer. They’re usually only discovered from a mammogram, as they don’t cause symptoms.

Breast calcifications may form as the body’s response to an injury.

There doesn’t appear to be a connection to consumption of calcium supplements and these formations.

Diagnosing breast calcification

If calcium is detected in a mammogram, your radiologist and doctor will try to figure out if the calcification is benign or connected with a cancer.

The calcification can occur in the glands (lobules) and ducts where milk is produced and carried to the nipple. Calcium deposits in the lobules are almost always benign. But deposits in the ducts can occasionally be a sign of ductal carcinoma in situ (DCIS), a form of breast cancer.

If your doctor suspects even a chance of a malignancy, they’ll recommend a biopsy.

Biopsy types

There are several types of breast biopsy:

A core biopsy is done with a hollow needle that’s injected into the breast, after local anesthesia. The sample is removed and examined under a microscope.

Stereotactic biopsy is a type of core biopsy that also uses a hollow needle to take a small sample from breast tissue. In this case, a stereoscopic X-ray is used to guide the needle. It’s also minimally invasive, only using a local anesthetic.

A vacuum-assisted biopsy is done using a mammogram or ultrasound to guide a probe. After local anesthesia, a hollow probe is inserted through a small incision in the skin. The collected sample is then examined under a microscope.

Wire localization is a technique for pinpointing the area to be removed for study. It’s more invasive than the other three methods and so is considered a surgery.

After a local anesthetic is given, a radiologist uses a mammogram or ultrasound to guide a fine wire into the breast. The wire is left in place until the suspect area of the breast can be surgically removed for examination under a microscope. The surgery usually takes place the same day or the day after. There may be some pain or discomfort while the wire is in place.

The follow-up surgery is done under a general or local anesthetic. You may feel some soreness after the operation.

Breast calcification treatment

Most tests and biopsies show that breast calcifications are benign. But the biopsy may indicate an early development stage of breast cancer. In that case, your doctors will discuss what it means and your treatment options.

Breast lumps should be investigated by your doctor regardless of what you think is the cause. If the benign calcification is interfering with your clothing or you have concerns, talk to your doctor about having it removed. This can usually be done in the doctor’s office or in an outpatient procedure facility.

Benign breast calcifications don’t increase your risk of developing breast cancer. Approximately 95 percent of women who have abnormalities show up in their mammograms don’t have breast cancer.

Cardiovascular calcification can accumulate in the deposits, or plaque, that may form after an injury to the wall of an artery or vein. This is known as calcified plaque.

The presence of calcified plaques increases the risk of coronary artery disease, a symptom of which is chest pain. Calcified plaque in the neck (carotid arteries) and spine (vertebral arteries) may contribute to your risk of having a stroke.

Cardiovascular calcification treatments

If you have arterial calcification, you’re more likely to develop heart disease.

If you develop chest pain, your doctor may request a coronary artery scan (also called a heart scan and a calcium scan) to see if excess calcium is present. This can help your doctor decide whether heart disease is the cause. The test is done with a CT scanner, a type of X-ray machine that produces a three-dimensional view.

Presence of calcium in your arteries isn’t necessarily a cause for concern. A heart specialist can discuss with you your total heart attack risk, whether you should consider a coronary artery scan for calcium, and what treatment is best for you.

There is some evidence that taking supplemental vitamin K-2 could be a means of lowering calcium-associated health risks. Check with your doctor for the most current information on taking this supplement.

In the meantime, there are steps you can take right away until you see a doctor. Discover heart-healthy tips you can do daily at home.

Kidney stones are usually made up primarily of calcium. Your kidneys filter about 10 grams of calcium every day. When the body tries to remove a kidney stone by passing it through to the bladder and out during urination, it can be very painful.

Symptoms of kidney stones include slow or small amounts of urine at a time, intense pain in your side, or pain when you urinate.

Diagnosing kidney stones

Your doctor will examine your blood and urine, and ask about your diet. Kidney stones, combined with high levels of calcium in your urine, may be a sign that you’re losing calcium from bone.

Research indicates that restricting calcium in a person’s diet might actually increase formation of kidney stones. Conversely, researchers at Harvard Medical School found that women who ate a calcium-rich diet had a 40 percent lower risk of developing kidney stones.

High levels of calcium in both blood and urine may indicate a hyperactive parathyroid. Hyperparathyroidism leads to other problems related to calcium levels including kidney stones, cardiovascular disease, and osteoporosis.

Kidney stones treatment

If you have kidney stones and a high level of calcium in your urine, your doctor may prescribe a thiazide diuretic. This is a drug that promotes retention of calcium in your bones rather than it being released into your urine.

Dermatomyositis, also known as CREST syndrome, isn’t strictly a calcium deposit. It’s an inflammatory disease that produces a violet or deep red rash, usually on the face or upper body. Hard calcium deposits under the skin may be a symptom of this syndrome, however.

While it’s rare, dermatomyositis can affect both adults and children.

Some people claim that dimethyl sulfoxide (DMSO) helps to dissolve calcium deposits, but DMSO isn’t approved for this purpose.

DMSO is only approved by the U.S. Food and Drug Administration to treat interstitial cystitis, a chronic condition that inflames a person’s bladder.

Learn about the risks and benefits of using DMSO.

Q:

What is DMSO? And is it safe for use at home?

Anonymous patient

A:

DMSO is a by-product of wood pulp and paper processing. It’s used as a chemical solvent and penetrates the skin and cells easily, so it’s often found in creams applied to the skin. It’s known to work as an anti-inflammatory, clears up free radicals with its antioxidant properties, and is even used to protect tissue during chemotherapy or when exposed to freezing temperatures. The only approved use by the FDA, however, is as a bladder wash for urinary tract infections.

This medication may interact with other medications you may be taking, even when applied topically. Don’t use dimethyl sulfoxide if you’re pregnant, trying to become pregnant, or are breastfeeding. It’s possible to have an allergic reaction to DMSO.

There isn’t research right now to support at-home use, but I suspect over time other uses may be found that are effective. DMSO is commonly used as first aid for sports injuries such as a strained muscle. It’s added to other topical medications to enhance absorption. If you decide to try this product, read the warning labels, don’t apply it to open skin, and don’t take it orally. Choose a product that has a reputation for quality and purity. Do a patch test on your skin to see if you’re allergic. This may be an effective addition to the pain treatment approach for those with chronic pain.

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHTAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Calcium is a natural mineral that can deposit in many different organs of your body. Most of the conditions it produces are benign and easily managed, though others may require surgery or are signs of more serious underlying conditions.