MANUAL MINORS
Rotator cuff tendinitis is the inflammation of the tendons that make up the rotator cuff, a group of four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) that stabilise and allow shoulder movements.
This condition is commonly caused by overuse of the shoulder, repetitive overhead movements, or age-related wear and tear. If left untreated, it can progress to tendon tears or impingement syndrome.
Diagnosis
Diagnosis is based on a clinical history of shoulder pain, which worsens with overhead movements or when lifting objects. The pain is often worse at night and may radiate down the arm.
Physical examination includes tests like the Jobe test (to assess the supraspinatus), Neer test, and
Hawkins test, which reproduce pain by compressing the inflamed tendons. Magnetic resonance imaging (MRI) or ultrasound is useful for confirming the diagnosis and evaluating the degree of inflammation or tendon damage.
Differential Diagnosis
Pathology | Characteristics |
|---|---|
Impingement syndrome | Pain during overhead movements, with compression of the rotator cuff tendons |
Subacromial bursitis | Pain and tenderness in the top of the shoulder, with bursa inflammation |
Rotator cuff tear | Acute pain with significant weakness, especially when raising the arm |
Bicipital tendinitis | Pain in the front of the shoulder, particularly with flexion or supination movements |
Adhesive capsulitis (frozen shoulder) | Severe shoulder pain and stiffness, with limitation in all ranges of motion |
Emergency Management
Emergency management focuses on relieving pain and reducing inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) are administered, and ice can be applied to the affected area during the first 48 hours.
In cases of severe pain, a corticosteroid injection into the subacromial space can be considered to reduce inflammation. It is important to recommend rest and advise against activities that exacerbate the pain, such as lifting objects or performing repetitive overhead movements.
Definitive Treatment
Definitive treatment for rotator cuff tendinitis includes physiotherapy to strengthen the shoulder muscles, improve range of motion, and correct shoulder mechanics. Stretching exercises are essential to avoid stiffness and improve flexibility.
In more severe cases or those that do not improve with conservative treatment, arthroscopy may be necessary to treat the inflamed tendon, remove damaged tissue, or repair a partial tear. Postoperative rehabilitation is crucial to restore shoulder function and prevent future injuries.
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