What is the treatment for shoulder tendinitis?

From the Guidelines

Treatment for shoulder tendinitis typically involves a combination of rest, medication, physical therapy, and lifestyle modifications, with the goal of reducing pain and inflammation, promoting tendon healing, and restoring normal shoulder mechanics. Initially, rest the affected shoulder and avoid activities that worsen pain, as recommended by 1. Take non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (400-800mg three times daily with food) or naproxen (250-500mg twice daily) for 1-2 weeks to reduce pain and inflammation, as suggested by 1. Apply ice to the painful area for 15-20 minutes several times daily, especially after activity, to provide acute relief of tendinopathy pain, as recommended by 1.

Some key considerations for treatment include:

• Relative rest and reduced activity to prevent further damage and promote healing and pain relief, as recommended by 1
• Cryotherapy to provide acute relief of tendinopathy pain, as recommended by 1
• Eccentric strengthening exercises to stimulate collagen production and guide normal alignment of newly formed collagen fibers, as recommended by 1
• NSAIDs for short-term pain relief, as recommended by 1
• Topical NSAIDs as an alternative to systemic NSAIDs, with potentially fewer systemic side effects, as recommended by 1
• Locally injected corticosteroids for acute-phase pain relief, but with caution due to potential deleterious effects on the tendon, as recommended by 1

It's essential to note that most patients with overuse tendinopathies (about 80 percent) fully recover within three to six months with conservative treatment, as reported by 1. However, if pain persists beyond 6-8 weeks despite treatment, further evaluation may be necessary to rule out other conditions or consider additional interventions, such as surgery, which is an effective treatment option for patients who have failed conservative therapy, as recommended by 1.

From the FDA Drug Label

Naproxen has been studied in patients with rheumatoid arthritis, osteoarthritis, juvenile arthritis, ankylosing spondylitis, tendonitis and bursitis, and acute gout Improvement in patients treated for rheumatoid arthritis was demonstrated by a reduction in joint swelling, a reduction in duration of morning stiffness, a reduction in disease activity as assessed by both the investigator and patient, and by increased mobility as demonstrated by a reduction in walking time In patients with osteoarthritis, the therapeutic action of naproxen has been shown by a reduction in joint pain or tenderness, an increase in range of motion in knee joints, increased mobility as demonstrated by a reduction in walking time, and improvement in capacity to perform activities of daily living impaired by the disease Naproxen has been studied in patients with mild to moderate pain secondary to postoperative, orthopedic, postpartum episiotomy and uterine contraction pain and dysmenorrhea

The treatment for shoulder tendinitis may include naproxen, as it has been studied in patients with tendonitis and has shown to be effective in reducing joint pain and improving mobility 2.

• Naproxen may help reduce pain and inflammation associated with shoulder tendinitis.
• It is essential to follow the recommended dosage and consult a healthcare professional for proper diagnosis and treatment.

From the Research

Treatment Options for Shoulder Tendinitis

The treatment for shoulder tendinitis can vary depending on the severity and duration of the condition. Some of the treatment options include:

• Conservative treatment, such as rest, physical therapy, nonsteroidal anti-inflammatory drugs, and subacromial infiltration with corticosteroids 3
• Surgery, which is recommended when conservative treatment fails 3, 4
• Ultrasound therapy, which has been shown to promote angiogenesis and calcium uptake to fibroblasts, and can be effective in resolving calcifications of shorter disease duration 5
• Platelet-rich plasma injection, which has been reported to be effective in treating calcific tendinitis of the shoulder in some cases 6

Conservative Treatment

Conservative treatment is often the first line of treatment for shoulder tendinitis, and can include:

• Rest and physical therapy to reduce pain and improve range of motion
• Nonsteroidal anti-inflammatory drugs to reduce pain and inflammation
• Subacromial infiltration with corticosteroids to reduce inflammation and promote healing

Surgical Treatment

Surgical treatment may be necessary for patients with chronic calcific tendinitis who do not respond to conservative treatment. The goal of surgery is to remove the calcification and repair any damaged tissue. Surgical options may include:

• Arthroscopic surgery to remove the calcification and repair any damaged tissue
• Open surgery to remove the calcification and repair any damaged tissue

Emerging Treatments

There are also some emerging treatments for shoulder tendinitis, including:

• Platelet-rich plasma injection, which has been reported to be effective in treating calcific tendinitis of the shoulder in some cases 6
• Ultrasound therapy, which has been shown to promote angiogenesis and calcium uptake to fibroblasts, and can be effective in resolving calcifications of shorter disease duration 5