Calcinosis is the development of hard calcium deposits that form on the skin or in the body. There are four main types of calcinosis: dystrophic calcinosis, metastatic calcinosis, iatrogenic calcinosis and idiopathic calcinosis.
- Dystrophic calcinosis is the most common type of calcium deposit, where people do not have a higher than normal level of calcium and phosphate in their blood. Calcification tends to occur around the site of a recent surgery or wound. Simple acne or minor cuts may cause dystrophic calcinosis, which usually occurs in the presence of damaged skin or other soft tissues. Tissue damage from autoimmune disorders like lupus, rheumatoid arthritis or scleroderma can result in calcinosis around the damaged areas. An injured joint or a tumor can also damage surrounding tissue, prompting the formation of calcium deposits. Dystrophic calcinosis typically results in calcium lumps localized to the area of tissue damage. However, some autoimmune disorders that result in damage to soft tissues in multiple areas may cause a systemic distribution of calcinosis lumps.
- Metastatic calcinosisis caused by the presence of too much calcium and/or phosphate in a person’s blood. As a result, calcium deposits tend to build easily in various locations throughout the body. The main cause of metastatic calcinosis is a failure of the kidneys to rid the body of excess calcium and phosphates. Some other causes of metastatic calcinosis include:
- Overstimulation of the thyroid gland that can produce excessive calcium and phosphates in the blood supply.
- A deficiency of magnesium, a mineral required for proper calcium absorption.
- Diseases that destroy bone tissue, like Pagets Disease, or various bone cancers that cause metastatic calcinosis.
- Idiopathic calcinosis may arise in children born with birth defects of the soft tissues. Some conditions, like Down’s syndrome, increase vulnerability to calcium deposits.
- Iatrogenic calcinosis is usually localized to a single site where tissues have been damaged through surgery. For example, children who undergo frequent heel sticks to withdraw blood may develop calcium deposits on their heels.
While the pathology is not fully understood, there are many locations calcium deposits are found:
- If scar tissue calcifies, old injuries can result in calcium deposits. This is most typical on tendons and bone.
- Scleroderma, dermatomyositis and systemic lupus are all autoimmune diseases that can involve the development of calcium deposits, typically in the fingers.
- Calcific tendonitis is a condition that causes the formation of a small calcium deposit within the tendons of the rotator cuff.
- Calcium deposits can form in the blood vessels causing stiffening and contributing to atherosclerosis. This is not the type of calcium deposits a massage therapist would feel.
What Does It Feel Like?
Most early calcium deposits are very soft, but after a long time, they dry up and become chalk-like, sometimes even turning into bone. The probability of a massage therapist palpating a calcium deposit will depend on its location. A likely location is on the anterior border of the tibia, a bone prone to bumps and bruises. These likely will be felt under the skin, yet are attached to the bone.
Working with Calcinosis
Because most massage therapists are not licensed to diagnose medical conditions, it is important to have a client confirm the cause of any bodily lumps and bumps with his/her physician. An evaluation by a primary care physician can rule out anything more serious than a calcium deposit.
When the therapist knows the encountered bump is a calcium deposit, take relief in knowing that they generally are not dangerous. However, as the size of the deposit increases, it can put pressure on surrounding structures, causing inflammation and pain. As long as massage does not irritate the calcifications, they can be ignored.
Of interesting note to the massage therapist is that calcium deposits generally form at the body’s weakest points. Therefore, arthritic joints are highly prone to developing these protrusions. This knowledge can prompt the massage professional to find out more about a particular location, which may enhance the therapeutic purpose of a session. For example, being aware of a calcium deposit on the knee may prompt asking a client whether any pain or weakness exists around the joint. A positive response may indicate focused work on the musculature supporting the knee to relax any tightened muscles and increase circulation around the weakened joint.
The more knowledgeable massage therapists are about the anomalies they encounter, the more safe and effective treatment they can administer. While calcium deposits do not pose imminent danger to bodywork, a massage therapist will gain confidence in understanding why the bump might be there, and how they can provide the most therapeutic massage possible.