What is calcific tendinopathy?
Calcific tendinopathy, also called calcific tendinitis, is a build-up of calcium inside a tendon, most often a rotator cuff tendon in the shoulder. The cause is not fully understood. Some deposits cause few symptoms, while others cause severe pain, especially when the body starts to break the calcium down.
What is barbotage?
Barbotage is a minimally invasive treatment for calcium deposits. Under ultrasound guidance and local anaesthetic, a needle is placed into the deposit, and saline is repeatedly injected and drawn back to break the calcium up and wash it out.
It is usually finished with a steroid injection into the bursa above the tendon to settle inflammation. There is no general anaesthetic, no cut and no overnight stay.
Does barbotage work?
For most people, yes. Studies report significant improvement in pain and movement in around seven to eight out of ten patients, often within weeks, and it can save people from surgery. Results are best when the deposit is clearly seen on ultrasound and combined with physiotherapy afterwards.
Does barbotage hurt?
The area is well numbed, so most people feel pressure rather than pain during the procedure. A flare of pain for one to three days afterwards is common as the anaesthetic wears off; ice, rest and simple painkillers help. Many people say it is far easier than the pain of the deposit itself.
How long does it take to recover from barbotage?
Most people are back to light everyday activities within a few days and notice improvement within two to six weeks, as the remaining calcium clears and inflammation settles. Avoid heavy lifting and overhead work for about two weeks, then build up with physiotherapy.
Will the calcium come back?
It is uncommon. Most deposits that are successfully broken up do not return. Occasionally, a large or very hard deposit needs a second procedure.
Can calcific tendinopathy go away on its own?
Sometimes. The body can slowly reabsorb the calcium, but this can take months or years and is often the most painful phase. Barbotage speeds that process up. If your deposit is small or already breaking down, your consultant may suggest a steroid injection or physiotherapy first.
Do I need an X-ray first?
No. Ultrasound shows calcium deposits clearly and is used to guide the procedure, so you do not need an X-ray to book. If you have had an X-ray or scan before, please bring the report.
Can I drive after barbotage?
We recommend you do not drive yourself home: the arm can be numb and sore for several hours. Arrange a lift or take public transport, and avoid driving until you can move the shoulder comfortably, usually after a day or two.
How much does barbotage cost?
At Harley Street Ultrasound barbotage is £625, all fees inclusive: the consultant assessment, diagnostic ultrasound, the barbotage, the steroid injection into the bursa, local anaesthetic and your written report. If the scan shows a steroid injection alone is the better option, that is £525.
What happens if I don’t need an injection?
We will never give you an injection you do not need. Every appointment starts with a diagnostic ultrasound of your shoulder, and if your consultant decides an injection is not the right treatment, it simply does not go ahead. You are charged our standard diagnostic ultrasound rate, not the treatment price.
You still leave with a clear plan: physiotherapy, a different treatment, an MRI, or a referral to the right specialist, with your report and images on your secure portal.
Do I need a referral?
No. Harley Street Ultrasound is a private clinic, so you can book an ultrasound-guided shoulder injection in London directly, online or by phone: no GP letter and no waiting list. If you are searching for shoulder injections near me in central London, we are at 99 Harley Street, a short walk from Regent’s Park and Oxford Circus stations.
Prices are published before you book and are all fees inclusive: the consultant assessment, the diagnostic ultrasound, the guided injection, local anaesthetic and your written report. Insured patients should check with their insurer and bring an authorisation number if their policy requires one.
Will I get a report?
Yes. Your consultant explains the scan findings and the treatment in the room, and a written report with your images is published to your secure patient portal, usually the same day, ready to share with your GP, physiotherapist or surgeon.
Can I still use the NHS afterwards?
Yes: completely. Coming to us privately never affects your NHS care. Your report and images can be shared with your NHS GP or consultant, and if anything needs onward NHS care, your consultant writes to your GP so you re-enter the pathway with a diagnosis already in hand.
