Pain in shoulder is one of the most common complaints that people have. The shoulder joint faces lot of stress and strain with regular activities. Shoulder joint is a complex joint supported by muscles and tendons to keep it stable. External trauma as well as daily stretch and strain can make the shoulder vulnerable to many problems.
Shoulder tendonitis or tendinitis is one such common problem. Tendonitis is basically inflammation of tendon. They are the end portion of muscles which attaches the muscle to the bone. An inflammation in the tendon can cause pain and stiffness in the affected joint.
What Causes Tendonitis Of The Shoulder?
The primary reason for shoulder tendonitis is inflammation of rotator cuff tendon. The shoulder joint is made up of three bones, the upper arm bone called humerus, the shoulder blade called scapula and the thin clavicle or the collar bone. The upper head of humerus is round like a ball and it is fixed in groove of the shoulder blade. The ball of upper arm bone remains in place as it is supported by the rotator cuff tendon.
Shoulder tendonitis occurs when the tendon is compressed by the surrounding structures which also include bones. Repeated microscopic injury to the tendon can cause inflammation. It is common in certain sports where the player requires lifting his arm above his head.
Persons paying baseball, tennis and other racket sports, weightlifting etc are susceptible of suffering from shoulder tendonitis. It is caused due to microscopic tear in the tendon due to repeated strain and stress while playing.
When the rotator cuff becomes inflamed or irritated it may get compressed in the acromion process of the scapula. The condition may also develop due to minor injury to the shoulder joint, where the tendon is damaged. In some cases it develops without any apparent cause.
Symptoms Of Shoulder Tendonitis
Pain in front of the shoulder is first symptom of shoulder tendonitis. There is swelling and tenderness. Patient may suffer from pain and stiffness when he lifts his arm. The shoulder is also painful when the arm is lowered after lifting. In the beginning the pain and stiffness is mild and the patient may not seek any treatment. Here are the clinical features suggestive of shoulder tendonitis.
- Radiating pain from front of the shoulder to the sides.
- Minor pain present with rest as well as activity.
- Pain with lifting the hand over the head.
- Patient may not be able to play sports which require throwing.
- If the condition becomes chronic there is pain at night.
- With pain there is weakness of shoulder.
- Patient is unable to move his arm behind the back while buttoning.
How To Treat Shoulder Tendonitis?
There are two goals considered for treating shoulder tendonitis. The first is to reduce pain and second obvious reason is restoration of function. After physical examination, medical history and other tests the doctor may be able to plan the treatment.
- Rest: Avoiding strenuous activities and giving rest to shoulder joint helps to heal the damaged tendon.
- Ice fomentation alternating with hot fomentation will also help to reduce inflammation in the tendon and increase circulation. Both will encourage healing.
- Use of NSAID’s will help to reduce swelling as well as pain.
- After few weeks, when patient slightly feels better the doctor may advice for physical therapy. The physiotherapist will help to improve the range of motion. Other exercises and short wave diathermy will help to heal the damaged tendon.
- Steroid injection: If all the above measures fail, use of steroid injection will help to alleviate the pain and inflammation.
Surgery is the last option when all other measures fail and patient finds difficult to move his arm.