If you still have a lot of rotator cuff pain, a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, may be helpful. Later, exercises can be started to strengthen the muscles and improve range of motion.ĭuring the first few days of rotator cuff tendonitis, apply an ice pack to the shoulder for 15 to 20 minutes every four to six hours. Early on, the aim is to reduce swelling and inflammation of the tendons and relieve compression in the subacromial space. The minimum time for recovery from rotator cuff tendonitis or a small tear is generally two to four weeks, and stubborn cases can take several months. However, not all types of tears can be treated arthroscopically. All three procedures have similar long-term results, although less invasive procedures usually result in shorter hospital stays and less postsurgical pain. Some surgeons use a technique called "mini-open repair," which is somewhat less invasive and uses a smaller incision. The operation can be performed arthroscopically - a minimally invasive procedure in which surgical instruments are inserted through several tiny incisions - or through standard open surgery, which requires a larger incision. Many orthopedic surgeons prefer to reserve surgery for younger patients, major tears that are diagnosed early, and older people whose occupations or activities place heavy demands on their shoulders. Those caused by traumatic injury to the shoulder are often repaired surgically. Minor ones can be treated conservatively, like tendonitis, but major ones may require an operation. Up to one-third of older people with rotator cuff tendonitis have a tear. What about a rotator cuff tear?Īs we get older, tendon tissue thins out and a tear becomes more likely. Because it's difficult to assess strength when the shoulder hurts, your clinician may inject a numbing agent (lidocaine) to deaden the pain before making an evaluation. Pain with normal muscle strength suggests rotator cuff tendonitis pain with weakness may indicate a tear (see "What about a rotator cuff tear?"). Your muscle strength and the shoulder's range of motion will also be tested. Your clinician will also check for tenderness at a point near the top of the upper arm (the subacromial space) and look for pain as the arm is raised and moved in certain ways. However, if you've suffered a traumatic injury or the shoulder hasn't improved with conservative therapy, or if a tear is suspected, an x-ray or MRI may be ordered. Most clinicians diagnose rotator cuff tendonitis by taking a history and performing a physical examination. Rotator cuff tendonitis usually starts with inflammation of the supraspinatus tendon and may involve the three other tendons as the condition progresses. The tendons work together to stabilize the joint, rotate the shoulder, and lift the arm above the head. The rotator cuff comprises four tendons - the supraspinatus, infraspinatus, teres minor, and subscapularis each of them attaches a muscle of the same name to the scapula (shoulder blade) and the humerus, or upper arm bone (see illustration). Fortunately, rotator cuff tendonitis and even tears can usually be treated without surgery. When severe, tendonitis can lead to the fraying or tearing of tendon tissue. Eventually, the pain may become more severe and extend over the entire shoulder. Lying on the affected shoulder also hurts, and the pain may wake you at night, especially if you roll onto that shoulder. The earliest symptom is a dull ache around the outside tip of the shoulder that gets worse when you push, pull, reach overhead, or lift your arm up to the side. The most common cause of shoulder pain is rotator cuff tendonitis - inflammation of key tendons in the shoulder. The risk is greatest for people with occupations or hobbies that require repetitive or overhead movements, such as carpenters, painting, tennis, or baseball. For younger people, sports injuries are the main source of trouble, but the rest of us have more to fear from the normal wear and tear that, over time, weakens shoulder tissues and leaves them vulnerable to injury. We use this mobility in so many activities that when the shoulder hurts, it can be disabling. Swinging a tennis racket, digging in the garden, placing a book on a high shelf, and reaching back to insert your arm into a sleeve - these are some of the movements made possible by the shoulder's enormous range of motion. The best way to treat rotator cuff tendonitis, the most common cause of shoulder pain, is with simple home therapies.
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