Rotator Cuff Tendonitis and Bursitis of the Shoulder
There are many causes of sho ulder pain, the most common are those associated with the rotator cuff. The shoulder is made up of a ball (the head of the humerus) in a socket (the glenoid part of the shoulder blade) and is covered by the rotator cuff. The rotator cuff consists of muscles that become tendons and attach to the humeral head. Through this attachment, the rotator cuff tendons stabilize the ball in the socket. They are working the hardest during such activities as throwing, reaching above shoulder height and repetitive functions. When you raise your arm up overhead, the rotator cuff tendons come into contact with another part of the shoulder blade called the acromion. When the tendon is inflamed or the bone has a spur on it, then this contact can be painful. The bursa is a normal lubricating structure placed between the tendon and the acromion to provide protection. When the bursa gets inflamed then this is ano ther cause for shoulder pain known as bursitis.
People may develop tendonitis or bursitis of the shoulder from having done overhead or repetitive activities with the arm. Sometimes, there is no obvious cause. It can develop slowly over time or quite suddenly with a single event. Patients with bursitis will complain about some or all of the following: burning pain at rest that feels like an ache in the upper arm, pain with reaching overhead such as to comb one’s hair, or reach onto a shelf, pain with reaching behind such as to fasten a bra, put on a coat or reach into a pocket.
In addition, patients with a rotator cuff problem may have many of the same symptoms but also will commonly complain of nighttime pain, pain with throwing, pain with repetitive movements and holding an object out away from the body such as one would do when reaching into the refrigerator to get a carton of milk.
The treatment for your shoulder problem will depend upon the severity of your pain and the functional limitations it places upon you. The symptoms of pain will be helped by anti- inflammatory medicine (“arthritis pills”) some of which can be bought in a pharmacy without prescription. Sometimes the pain may be so intense you can’t sleep or even do everyday activities and an injection of cortisone may be helpful. Once the pain is under control, then a course of physical therapy is often useful to restore your flexibility and strength of your rotator cuff muscles and tendons.
Activity modification is an important part of the treatment of shoulder tendonitis and bursitis. Learning what activities aggravate your pain and avoiding them when possible will allow the inflammation to go away. When all of the non-surgical means of treating your shoulder condition are exhausted and your problem is still present, then surgery becomes a viable alternative. The surgical treatment for the rotator cuff will be discussed in a separate section.