Those affected tend to hold the shoulder rotated inwards to alleviate pain, and have difficulty lying on the affected shoulder. Some people experience heat and redness at the affected shoulder, as well as a limited range of motion. Cause
Calcific tendinitis is caused by deposits of calcium phosphate crystals in the tendons of the shoulder. These deposits are most frequently found in the supraspinatus tendon (63% of the time), and less frequently in the infraspinatus tendon (7%), subacromial bursa (7%), subscapularis tendon (3%), or in both the supraspinatus and subscapularis tendons at the same time (20%).The development of calcific tendinitis is often divided into three stages. First, in the "precalcific stage", something causes tendon cells to transform into other cells that can act as sites for calcium deposition. This is followed by the two-part "calcific stage"; first calcium is deposited (the formative phase), then the body begins to break down the calcium deposit (the resporptive phase). Finally, in the "postcalcific stage" the calcium deposits are replaced with new tissue and the tendon completely heals.The cause of the calcium deposits remains unclear, although several theories have been put forward. Some theories involve the differentiation of tendon cells into other cells, namely cartilages or bone cells. Others associate the condition with cell death due to aging, wear, or lack of oxygen in the tissue; however, the disease is uncommon in the very old, not associated with exercise, and tends to resolve completely even if untreated. Diagnosis
Calcific tendinitis is typically diagnosed by physical examination and X-ray imaging.
Treatment
If a cause can be identified for a burning sensation in the mouth, then treatment of this underlying factor is recommended. If symptom persist despite treatment a diagnosis of BMS is confirmed. BMS has been traditionally treated by reassurance and with antidepressants, anxiolytics or anticonvulsants. A 2016 Cochrane review of treatment for burning mouth syndrome concluded that strong evidence of an effective treatment was not available, however,  a systematic review in 2018 found that the use of antidepressants and alpha-lipoic acids gave promising results.Other treatments which have been used include atypical antipsychotics, histamine receptor antagonists, and dopamine agonists. Supplementation with vitamin complexes and cognitive behavioral therapy may be helpful in the management of burning mouth syndrome. Prognosis
BMS is benign (importantly, it is not a symptom of oral cancer), but as a cause of chronic pain which is poorly controlled, it can detriment quality of life, and may become a fixation which cannot be ignored, thus interfering with work and other daily activities. Two thirds of people with BMS have a spontaneous partial recovery six to seven years after the initial onset, but in others the condition is permanent. Recovery is often preceded by a change in the character of the symptom from constant to intermittent. No clinical factors predicting recovery have been noted.If there is an identifiable cause for the burning sensation, then psychologic dysfunctions such as anxiety and depression often disappear if the symptom is successfully treated. Epidemiology
BMS is fairly uncommon worldwide, affecting up to five individuals per 100,000 general population.