Rotator cuff pain

Rotator cuff pain is most usually experienced when the arm is raised or lifted in an arc away from the body, if you’re not already familiar with the body’s physiology you might just think you have an awkward shoulder pain. However, also known as painful arc syndrome, rotator cuff pain in the shoulder is caused by a partial rotator cuff tear, often resulting from a fall when the shoulder muscles and tendons take the main strain of arresting the fall.

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What causes a rotator cuff tear?

The rotator cuff itself is a reinforcing structure around the shoulder joint made up of four muscle tendons, which merge with the fibrous capsule enclosing the joint. In extreme cases a complete tear can occur rendering the shoulder virtually immoveable, this type of severe disability accompanied by severe neck and shoulder pain will frequently require surgery to correct; whereas the more common partial tear can be treated without recourse to surgery. So, whilst someone experiencing shoulder pain following a fall may well suspect a rotator cuff injury – should someone experiencing a pain in shoulder or neck areas that hasn’t had a fall also suspect a rotator cuff tear? The answer is most probably yes! Rotator cuff damage can also arise as a form of tendinitis or repetitive strain injury. Subsequently, sportsmen and women who repeatedly throw things can especially succumb to neck and shoulder pain; as to can swimmers, kayakers, rowers and even people like musical conductors!

Non-surgical treatment for rotator cuff pain.

Whilst anything up to 90% of rotator cuff injuries, and the shoulder pain arising from them, will be long term in nature, providing the neck and shoulder pain isn’t too intense or debilitating recourse to surgical treatment can be avoided. Being a form of tendinitis the primary treatment recommended by a medical practitioner for rotator cuff shoulder pains and referred neck and shoulder pains will be rest. Quite simply by resting the damaged tissues they can start the self-healing process. However, and of course, keeping a shoulder immobile is pretty well impossible to do, so it is more a question of being conscious of the shoulder pain and limiting any shoulder movements. Other suggestions will include applying a cold compress to reduce inflammation and control any swelling, as will raising the affected part of the body – although in the case of rotator cuff injuries this is difficult to achieve. Following an initial period of rest it is advisable to begin exercising the rotator cuff to help promote the self-healing process. There are a series of exercises specifically designed to gradually restore the rotator cuff to health without causing further damage or increasing the feelings of having a pain in shoulder problem.

Surgical treatment for rotator cuff pain.

If non-surgical treatment fails to work then some sufferers of “pain in shoulder” syndromes, arising from rotator cuff injuries, do have surgery to repair the injury, removing the neck and shoulder pain as well as restoring full mobility to the shoulder in less time than non-surgical treatment would take. The decision to undergo surgery isn’t always due solely to the neck and shoulder pain being experienced, but could be due to the nature of having a restricted shoulder movement, affecting either the ability to work or perhaps play and enjoy a particular sport of hobby. For a tear that is either less than 50% of the rotator cuff thickness or less than 1cm in size, the dead tissue can be removed arthroscopically, requiring only a small incision and an arthroscope then being passed into the joint. This prevents the joint itself having to be opened up; the surgeon simply removes the dead tissue via the arthroscope, leaving only a small surface wound to heal over. For more serious cases a procedure called acromioplasty is required. Acrimoplasty is the removal of a bone’s surface that is in contact with the damaged tendon tissue, in the case of rotator cuff shoulder pain, the coracoacromial ligament is removed in order to repair the rotator cuff tendon.

Sources

  1. http://www.guideline.gov/summary/summary.aspx?doc_id=14584&nbr=7258&ss=6&xl=999
  2. http://www.nlm.nih.gov/medlineplus/ency/article/000438.htm
  3. http://www.umm.edu/orthopaedic/rotator_cuff.htm
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