Rotator Cuff Tendonitis
What is Rotator Cuff Tendonitis?
The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint providing movement and stability to the shoulder. Inflammation of the rotator cuff tendons is called rotator cuff tendonitis or shoulder impingement. The inflammation leads to thickening of the tendons causing space reduction that may squeeze or compress the rotator cuff muscle between the acromion process of the shoulder blade and the humoral head of the arm. This compression results in pain, tenderness, swelling, warmth and redness in the shoulder.
Relevant Anatomy
Three bones, namely the upper arm bone (humerus), the shoulder blade (scapula) and the collar bone (clavicle) join together to make the shoulder joint.
The acromion is a protuberance of the shoulder bone or scapula. Ligaments are the thick strands of fibers that connect bone to bone. Ligaments connect the collar bone to the shoulder blade at the acromion process.
Causes of Rotator Cuff Tendonitis
Rotator cuff tendonitis may occur due to:
- Bony growth of the acromion process
- Inflammation of the bursa fluid (bursitis).
- Degeneration of the tendons with age particularly above 40 years old
- Overuse injury of the tendons: This occurs more often in people in certain professions and in sports requiring repetitive shoulder movement such as tennis players, swimmers, construction workers, and painters.
- Trauma or injury: one hard throw can cause the problem to occur.
Diagnosis of Rotator Cuff Tendonitis
Diagnosis involves physical examination by the doctor. X-rays are ordered to nullify other causes of the pain such as arthritis or to check if shoulder impingement is due to a bone spur. Soft tissues such as muscle and tendons cannot be seen by X-ray so an ultrasound or MRI scan may be ordered to see if shoulder tendinitis is present.
Your doctor may give an injection of an anesthetic drug in the space below the acromion to see if it provides relief for the pain. If it does, it confirms that the pain was due to rotator cuff tendinitis or shoulder impingement.
Treatment of Rotator Cuff Tendinitis
Treatment generally involves avoiding overhead activities totally for a time to rest the affected tendons and muscles. Non-steroidal anti-inflammatory medicines are given to reduce inflammation and thus help in decreasing pain and swelling. Some shoulder muscle strengthening exercises are also advised. If this does not provide relief an injection of local anesthetic and corticosteroid, a strong anti-inflammatory agent, may be given. The condition usually takes a few months to recover completely. If conservative treatment measures do not resolve the problem, your doctor may recommend surgery to create more space for the rotator cuff by removing part of the acromion bone.
