Rotator Cuff Tendinitis

What is Rotator Cuff Tendinitis?

Shoulder pain is a very common complaint in the primary care setting because shoulder has one of the most complex joints in the body and provides an incredible range of motion. Inflammation of the key tendons in the shoulder is the most common cause of shoulder pain and known as rotator cuff tendinitis. Rotator cuff tendinitis is more likely to occur as people age due to wear and tear and more prevalent in people who routinely perform activities that require repetitive movement that increases stress on susceptible tendons. The rotator cuff consists of the tendons of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles, and inserts on the humeral tuberosities. Of the rotator cuff tendons, the supraspinatus tendon is most important and most vulnerable, and it is essential for lifting the arm. The other three tendons are also gradually affected as the condition progresses.

What causes Rotator Cuff Tendinitis?

  • Aging. Usually 40yrs and older.
  • Repetitive overhead activity from work
  • Athletes such as swimmers, pitchers, and those that play tennis and volleyball.

What are the symptoms of Rotator Cuff Tendinitis?

  • Pain and swelling in the front of your shoulder and side of the arm 
  • Loss of strength and motion in the affected arm
  • Pain when raising or lowering your arm
  • Painful daily activities with putting on a shirt or brushing hair
  • Stiffness and clicking sound when raising your arm
  • Shoulder pain that interferes with sleep
  • pain when reaching behind your back

How to diagnose Rotator Cuff Tendinitis?

The diagnosis of rotator cuff tendinitis usually begins with a thorough and careful medical history, associated symptoms, and physical examination. Physical examination usually includes testing the shoulder range of motion and muscle strength. A local anesthetic may be injected into the shoulder joint to differentiate rotator cuff tendinitis from tear. The anesthetic relieves pain in people with tendinitis and muscle strength is usually normal while people with a tear will experience pain relieves but no improvement in the muscle function. If symptoms do not improve after conservative treatment, an imaging test such as X-ray or MRI may be ordered especially when rotator cuff tear is suspected.

What are the treatments of Rotator Cuff Tendinitis?

The goal of treatment is to reduce pain and restore function. Conservative treatment is always the first treatment approach in the rotator cuff tendonitis and includes:

  • Avoids activities that triggered the pain such as lifting
  • Apply cold packs to the affected area.
  • Take nonsteroidal anti-inflammatory drugs to reduce shoulder pain.
  • Physical therapy focus on rotator cuff strength and function exercises.
  • Cortisone injection when NSAID and physical therapy do not reliever the shoulder pain

What are the surgical treatments of Rotator Cuff Tendinitis?

Surgery is recommended if a conservative approach fails to address the symptoms. The goal of surgery is to create more space for the rotator cuff. These procedures can be performed using either an arthroscopic or open technique.

  • Open Repair Surgery: Open repairs require a three- to four-inch incision in the front of the shoulder to see the rotator cuff and acromion directly. This technique is usually reserve for large rotator cuff tear and less likely to be used in tendinitis
  • Arthroscopic Surgery: It is less invasive and the preferred method because patients experience less pain and faster return to normal activities. The procedure requires two or three smaller incisions through which a fiberoptic scope with a camera and light and other instruments are inserted to removes bone and soft tissue

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