Shoulder tendinitis – Causes, Symptoms, Treatments, and Prevention

Dr. Raam Mohan, MS Ortho

Telemedicine Department

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What is Shoulder Tendinitis?

Shoulder tendinitis is swelling and inflammation of tendons around the shoulder. They are the most common causes of shoulder pain. 

Anatomy

The shoulder joint is made up of two bones- the upper arm bone called the humerus and the shoulder bone called the scapula. Around the joint, there is a thick group of muscles called Rotator cuff muscles which, along with other ligaments, stabilises the shoulder joint. 

Where the injury occurs?

The main component of the cuff is the supraspinatus tendon which is very prone to overuse and injury. Inflammation of this tendon is called rotator cuff or supraspinatus tendinitis. Surrounding this rotator cuff is a fluid-filled space called a subacromial bursa. Any wear and tear in the tendon cause irritation of this nearby bursa producing the disease called subacromial bursitis. Both these conditions frequently coexist and are the most common cause of shoulder pain.

Causes of Shoulder Tendinitis?

It is common in people with frequent overhead activities. Professional workers and industrial labourers who deal with heavy weight lifting are prone to injury. When the same activity is being done over and over, it can cause chronic injury. However, it is a common sports injury where any heavy throw can cause micro-tears in the tendon and cause acute supraspinatus tendinitis. When the injury is left untreated, it can even progress to rotator cuff full-thickness tears and retraction. In such conditions, there will be a loss of muscle power in addition to Pain. 

Symptoms of Shoulder Tendinitis

• Pain in the front of the arm
• Pain increased while doing overhead activities
• Stiffness and difficulty in reaching behind your back
• Clicking sound on the lifting arm

How is Shoulder Tendinitis treated?

• For acute tears, rest is the mainstay treatment. Ice fomentation and temporary immobilisation are given with braces. 
• Oral NSAIDS group of drugs are given for pain relief. 
• After giving a period of rest, rehabilitation is started with shoulder mobilisation and girdle strengthening exercises. 
• Newer techniques of Intraarticular injection with PRP(Platelet-rich plasma) are under trial, which helps in better healing. 
• Surgery is indicated mainly for those with partial or complete tears of the tendon. Using minimally invasive key-hole techniques, the torn and retracted tendons are anchored back to their original insertion using special orthopaedic implants. The subacromial bursa can also be removed using keyhole arthroscopy techniques. 

Prevention of Shoulder Tendinitis

Proper exercise every day will lubricate the shoulder joint and strengthen the surrounding cuff muscles. Any repeated heavy overhead activities must be regularised with adequate breaks. Sports persons must do warm-up and stretching exercises before they get into action.  

Conclusion

Approaching the doctor on time will help in the timely diagnosis of where exactly the pain is initiated, and the treatment started as fast as possible. Only then the recovery phase, though it should be taken slow, will go smooth. Never try to hasten the recovery phase through any internet-based modern methods. Take the utmost care to make sure recurrence does not occur.

FAQ