From the Guidelines
Rotator cuff tendinitis is primarily caused by repetitive overhead activities, aging, poor posture, and trauma to the shoulder, and treatment begins with rest and activity modification to avoid painful movements, as recommended by recent studies 1. The condition occurs when shoulder tendons become irritated and inflamed from overuse or injury, causing the protective bursa to become inflamed as well, resulting in pain and limited mobility. Some key factors that contribute to the development of rotator cuff tendinitis include:
- Repetitive lifting or overhead activities, which can cause wear and tear on the tendons 1
- Aging, as people older than 40 years are at greater risk 1
- Poor posture, which can put strain on the shoulder muscles and tendons
- Trauma to the shoulder, such as a fall or shoulder dislocation 1 Treatment options for rotator cuff tendinitis include:
- Over-the-counter pain medications like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) to reduce inflammation and pain for 1-2 weeks 1
- Applying ice to the affected area for 15-20 minutes several times daily to decrease inflammation
- Physical therapy focusing on gentle stretching and strengthening exercises, typically 2-3 sessions weekly for 4-6 weeks 1
- A home exercise program that includes pendulum stretches, wall crawls, and external rotation exercises performed daily
- Corticosteroid injections for persistent pain, which can provide temporary relief 1
- Surgery, which is rarely needed unless there's a significant tear 1 Prevention strategies include:
- Proper warm-up before activities
- Maintaining good posture
- Avoiding repetitive overhead movements
- Strengthening shoulder muscles regularly It's essential to note that most cases of rotator cuff tendinitis improve within 3-6 months with conservative treatment 1, and surgery should be reserved for patients who have failed conservative therapy.
From the Research
Causes of Rotator Cuff Tendinitis
- Rotator cuff injuries are usually a result of microtrauma from repetitive movements 2
- Classic, or primary, impingement results directly from overhead motions, and secondary impingement is related to underlying shoulder instability 2
- Rotator cuff injury is a common clinical disorder of the musculoskeletal system and one of the most common causes of shoulder pain and shoulder joint dysfunction 3
Treatments for Rotator Cuff Tendinitis
- Nonoperative treatment, which may include steroid injections, is often effective for an inflamed rotator cuff tendon 2
- Surgery is indicated if the patient has no improvement after at least 6 weeks of physical therapy 2
- Corticosteroid injections combined with hyaluronic acid injections can be used for the non-surgical conservative clinical management of rotator cuff injuries 3
- Platelet-rich plasma (PRP) injection is a valid alternative to corticosteroid injections in the treatment of rotator cuff tendinopathy 4, 5, 6
- PRP renders similar results to that of corticosteroids in most clinical aspects among patients with RC tendinopathies; however, pain and ROM may show more significant improvement with the use of PRP 4
- Corticosteroid injection yielded statistically significant superior functional recovery and pain relief compared with PRP injection for rotator cuff lesions during the short-term follow-up period, but no statistically significant difference was identified between the 2 groups at the medium-term and long-term follow-up 5