Rotator Cuff Syndrome

Description

The rotator cuff consists of four tendons that stabilize and potentiate motion at the shoulder in concert with four muscles. These muscles include the subscapularis, the supraspinatus, the infraspinatus, and the teres minor.

Causes

Wear and tear with ageing, causing the rotator cuff tendons to thin and become progressively fragile.

Overactivity with frequent movement of the arm(s) overhead in sports, weight-lifting or manual labor

Excessive force to the rotator cuff tendons as in an accident or fall

Symptoms

  • Pain when moving the arm overhead

  • Pain at rest

  • Shoulder locked in place

  • Arm and hand weakness

  • Crepitus with shoulder motion

  • Popping sensation with arm motion

Diagnosis

The physician will take a careful history and perform a physical exam. The exam will assess for tenderness in different parts of the shoulder by palpation and range of motion testing. The strength of the muscles around your shoulder and in your arms will be assessed as well. X-rays can be used to visualize bony abnormities like spurs and arthritis. An ultrasound can be used to examine the rotator cuff tendons and muscles as can an MRI, which highlights soft tissue structures in detail.

Management

Conservative management with over-the-counter pain medications is the preferred mode of treatment for mild cases of rotator cuff syndrome. Over-the-counter pain medications can include aspirin, ibuprofen and naproxen. Rest and cold packs are beneficial initially. After the pain starts to diminish, heating pads and stretching can assist with recovery.

If conservative measure do not result in significant improvement of symptoms, a steroid injection can be performed by a knowledgeable and appropriately trained physician. A skilled physical therapist can aid in recovery as well.

Surgery is the last resort for rotator cuff syndrome unless it involves an acute injury that results in a significant tear or rupture of one or more rotator cuff tendons.