Rotator Cuff Bursitis and Tendinitis
One of the most common physical complaints is shoulder pain. Your shoulder is made up of several joints combined with tendons and muscles that allow a
great range of motion in your arm. Because so many different structures make up the shoulder, it is vulnerable to many different problems. The
rotator cuff is a frequent source of pain in the shoulder
Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
Your arm is kept in your shoulder socket by your rotator cuff. These muscles and tendons form a covering around the head of your upper arm bone
and attach it to your shoulder blade.
There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator
cuff tendons to glide freely when you move your arm.
The rotator cuff is a common source of pain in the shoulder. Pain can be the result of:
The rotator cuff tendons can be irritated or damaged.
The bursa can become inflamed and swell with more fluid causing pain.
When you raise your arm to shoulder height, the space between the acromion and rotator cuff narrows. The acromion can
rub against (or "impinge" on) the tendon and the bursa, causing irritation and pain.
Rotator cuff pain is common in both young athletes and middle-aged people. Young athletes who use their arms overhead for swimming, baseball,
and tennis are particularly vulnerable. Those who do repetitive lifting or overhead activities using the arm, such as paper hanging,
construction, or painting are also susceptible.
Pain may also develop as the result of a minor injury. Sometimes, it occurs with no apparent cause.
Rotator cuff pain commonly causes local swelling and tenderness in the front of the shoulder. You may have pain and stiffness when you lift your arm.
There may also be pain when the arm is lowered from an elevated position.
Beginning symptoms may be mild. Patients frequently do not seek treatment at an early stage. These symptoms may include:
Minor pain that is present both with activity and at rest
Pain radiating from the front of the shoulder to the side of the arm
Sudden pain with lifting and reaching movements
Athletes in overhead sports may have pain when throwing or serving a tennis ball
As the problem progresses, the symptoms increase:
Pain at night
Loss of strength and motion
Difficulty doing activities that place the arm behind the back, such as buttoning or zippering
If the pain comes on suddenly, the shoulder may be severely tender. All movement may be limited and painful.
The goal of treatment is to reduce pain and restore function. In planning your treatment, your doctor will consider your age, activity level, and general health.
In most cases, initial treatment is nonsurgical. Although nonsurgical treatment may take several weeks to months, many patients
experience a gradual improvement and return to function.
Rest. Your doctor may suggest rest and activity modification, such as avoiding overhead activities.
Non-steroidal anti-inflammatory medicines. Drugs like ibuprofen and naproxen reduce pain and swelling.
Physical therapy. A physical therapist will initially focus on restoring normal motion to your shoulder. Stretching exercises to improve range of
motion are very helpful. If you have difficulty reaching behind your back, you may have developed tightness of the posterior capsule of the shoulder
(capsule refers to the inner lining of the shoulder and posterior refers to the back of the shoulder). Specific stretching of the posterior capsule can be very effective in relieving pain in the shoulder.
Once your pain is improving, your therapist can start you on a strengthening program for the rotator cuff muscles.
Steroid injection. If rest, medications, and physical therapy do not relieve your pain, an injection of a local anesthetic and a
cortisone preparation may be helpful. Cortisone is a very effective anti-inflammatory medicine. Injecting it into the bursa beneath the acromion
can relieve pain.
This information is not
meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.