The rotator cuff is a group of muscles that work together to help the shoulder move. Rotator cuff tendonitis occurs when the tendons that connect the muscles to the upper arm bone become inflamed. It is one of the most common causes of shoulder pain in people over the age of 40
Cause
In many cases, rotator cuff tendonitis develops when one of the tendons becomes irritated, which leads to inflammation. The bursae, which lines the tendon, also can become inflamed.
The tendon can become irritated due to being pinched by other structures or from overuse. Repetitive activities, which involve overhead arm movements are often associated with rotator cuff tendonitis.
Symptoms and Natural History
The main symptom of rotator cuff tendonitis is pain in the shoulder. The pain is often in the front of the shoulder and can radiate down the arm, usually stopping at the elbow. It is also common for someone with rotator cuff tendonitis to have difficulty holding their arm overhead. Weakness in the shoulder may also occur.
Rotator cuff tendonitis often starts out with mild discomfort, which may only be present when doing certain shoulder movements. As the condition progresses, pain may be felt even at rest.
If rotator cuff tendonitis causes a great deal of pain, it can make performing activities that involve raising your arms overhead difficult. Work and recreational activities may need to be modified until effective treatment resolves the condition.
Diagnosis
To make a diagnosis, your doctor will examine your shoulder and check for tenderness and difficulty raising your arms overhead. Imaging tests may also be ordered to make a diagnosis. An ultrasound or MRI may be used to determine if there is inflammation of the rotator cuff.
Self-help Treatments for Rotator Cuff Tendonitis
Self-help treatments for rotator cuff tendonitis include applying heat and performing shoulder stretches to improve range of motion. In addition to heat, applying cold packs several times a day for about twenty minutes at a time may decrease inflammation.
Resting the shoulder can also allow the rotator cuff time to heal. For example, reducing repetitive activities that involve lifting the arms overhead or other shoulder movements that cause pain may be advised.
Standard Clinical Treatments Rotator Cuff Tendonitis
Physical therapy may be prescribed in some instances for rotator cuff tendonitis. Strengthening and range of motion exercises may be taught to reduce symptoms and prevent future flare-ups. Steroid injections may be administered if self-help treatments alone are not enough to reduce symptoms.
In many cases, a combination of the treatments listed above along with self-help treatments is enough to reduce symptoms. But in cases of severe rotator cuff tendonitis, surgery may be an option.
Surgery for rotator cuff tendonitis involves removing bone spurs, which may have led to inflammation. Surgery may also be performed to remove inflamed bursal tissue or repair a tendon.
Sources
Cleveland Clinic. Rotator Cuff Tendonitis. https://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/rotator-cuff-tendonitis
Johns Hopkins Medicine. Shoulder Tendonitis. http://www.hopkinsmedicine.org/healthlibrary/conditions/spine_shoulder_and_pelvis_disorders/shoulder_tendonitis_85,P01387/
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