Rotator Cuff Tendinitis

What is Rotator Cuff Tendinitis

Rotator cuff tendinitis is inflammation of the tough, cord-like bands that connect muscle to bone (tendons) in the rotator cuff. The rotator cuff includes all of the muscles and tendons that connect the arm to the shoulder.

The rotator cuff holds the head of the upper arm bone (humerus) in the cup (fossa) of the shoulder blade (scapula).

This condition can lead to a long-lasting (chronic) tear. The tear may be partial or complete.

What are the causes?

This condition is usually caused by overusing the rotator cuff.

What increases the risk?

This condition is more likely to develop in athletes and workers who frequently use their shoulder or reach over their heads. This can include activities such as:

  • Tennis.
  • Baseball or softball.
  • Swimming.
  • Construction work.
  • Painting.

What are the signs or symptoms?

Symptoms of this condition include:

  • Pain spreading (radiating) from the shoulder to the upper arm.
  • Swelling and tenderness in front of the shoulder.
  • Pain when reaching, pulling, or lifting the arm above the head.
  • Pain when lowering the arm from above the head.
  • Minor pain in the shoulder when resting.
  • Increased pain in the shoulder at night.
  • Difficulty placing the arm behind the back.

How is this diagnosed?

This condition is diagnosed with a medical history and physical exam. Tests may also be done, including:

  • X-rays.
  • MRI.
  • Ultrasounds.
  • CT or MR arthrogram. During this test, a contrast material is injected and then images are taken.

How is this treated?

Treatment for this condition depends on the severity of the condition. In less severe cases, treatment may include:

  • Rest. This may be done with a sling that holds the shoulder still (immobilization). Your health care provider may also recommend avoiding activities that involve lifting your arm over your head.
  • Icing the shoulder.
  • Anti-inflammatory medicines, such as aspirin or ibuprofen.

In more severe cases, treatment may include:

  • Physical therapy.
  • Steroid injections.
  • Surgery.

Follow these instructions at home:

If you have a sling:

  • Wear the sling as told by your health care provider. Remove it only as told by your health care provider.
  • Loosen the sling if your fingers tingle, become numb, or turn cold and blue.
  • Keep the sling clean.
  • If the sling is not waterproof, do not let it get wet. Remove it, if allowed, or cover it with a watertight covering when you take a bath or shower.

Managing pain, stiffness, and swelling

  • If directed, put ice on the injured area.
    • If you have a removable sling, remove it as told by your health care provider.
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Move your fingers often to avoid stiffness and to lessen swelling.
  • Raise (elevate) the injured area above the level of your heart while you are lying down.
  • Find a comfortable sleeping position or sleep on a recliner, if available.

Driving

  • Do not drive or use heavy machinery while taking prescription pain medicine.
  • Ask your health care provider when it is safe to drive if you have a sling on your arm.

Activity

  • Rest your shoulder as told by your health care provider.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Do any exercises or stretches as told by your health care provider.
  • If you do repetitive overhead tasks, take small breaks in between and include stretching exercises as told by your health care provider.

General instructions

  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay healing. If you need help quitting, ask your health care provider.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your pain gets worse.
  • You have new pain in your arm, hands, or fingers.
  • Your pain is not relieved with medicine or does not get better after 6 weeks of treatment.
  • You have cracking sensations when moving your shoulder in certain directions.
  • You hear a snapping sound after using your shoulder, followed by severe pain and weakness.

Get help right away if:

  • Your arm, hand, or fingers are numb or tingling.
  • Your arm, hand, or fingers are swollen or painful or they turn white or blue.

Summary

  • Rotator cuff tendinitis is inflammation of the tough, cord-like bands that connect muscle to bone (tendons) in the rotator cuff.
  • This condition is usually caused by overusing the rotator cuff, which includes all of the muscles and tendons that connect the arm to the shoulder.
  • This condition is more likely to develop in athletes and workers who frequently use their shoulder or reach over their heads.
  • Treatment generally includes rest, anti-inflammatory medicines, and icing. In some cases, physical therapy and steroid injections may be needed. In severe cases, surgery may be needed.
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