While there are many possible causes of shoulder pain, the most common is a rotator cuff tear. Approximately two million Americans go to the doctor each year for this problem. These injuries can be debilitating and frequently prevent you from sleeping, working, exercising or performing everyday activities.
What is the rotator cuff?
The rotator cuff is the group of four muscles and tendons that stabilize the ball and socket in the shoulder and allows you to lift your arm.
What causes a rotator cuff tear?
Over time, wear and tear can cause partial tearing of the rotator cuff. At first, the tear may not cause symptoms, until the shoulder is irritated or strained from a traumatic or overuse injury. Partial tears can enlarge into complete tears, where the tendon is completely detached from the bone. More severe rotator cuff injuries can cause weakness in lifting the arm.
If you are experiencing any of these symptoms, you may be suffering from a rotator cuff tear:
- Dull ache of your shoulder or arm
- Difficulty sleeping due to shoulder pain
- Weakness of the shoulder
- Difficulty lifting your shoulder above your head
- Muscle spasms with use of the shoulder
- Cracking or popping sounds associated with movement of the shoulder
Seeking medical attention
If your shoulder is interfering with your quality of life, consider speaking with your primary care doctor. They will likely refer you to an orthopedic specialist who will review your symptoms, examine your shoulder and obtain an X-ray of the shoulder to determine a diagnosis. If a complete tear of the rotator cuff is suspected, an MRI of the shoulder may be used to assess the severity of the injury.
Initial treatment options
Your doctor will formulate a treatment plan to best address your symptoms, with consideration to the severity of your rotator cuff injury, your age and activity level, and previous treatments you have attempted. Many rotator cuff tears can improve with non-surgical treatments including:
- Physical therapy (PT)
- Anti-inflammatory medication (NSAID)
- Corticosteroid (steroid) injection
Most patients with rotator cuff tears that respond to non-surgical treatment will see significant improvement within a few months.
Rotator cuff surgery
If you fail to improve with non-surgical treatments, your orthopedic specialist will discuss the option of surgery to repair the rotator cuff. The surgery can usually be performed arthroscopically as a same-day procedure. For a typical repair, you wear a sling for six weeks after surgery. Physical therapy would typically begin two weeks after surgery to regain your range of motion, with progressive strengthening over the next few months.
Shoulder specialist Matthew Boylan, MD says, “Rotator cuff injuries are among the most common problems that I see. Many of my patients improve with a physical therapy program to strengthen the shoulder and medication or an injection to reduce inflammation. If surgery is ultimately needed, I can use arthroscopic, minimally-invasive techniques to repair the rotator cuff to reduce your pain and get you back to the things you enjoy.”
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Additional Patient Resource:
Rotator Cuff Tears: Frequently Asked Questions (https://orthoinfo.aaos.org/en/diseases–conditions/rotator-cuff-tears-frequently-asked-questions/)