Shoulder Tendinitis is an inflammation that causes intense pain that tends to worsen with arm movements. Its treatment includes the use of medication, physiotherapy and, in some cases, surgery. Shoulder tendinitis has a cure, but the complete remission of symptoms can take months to achieve.
The most common form of shoulder tendinitis involves the tendon of the supraspinatus muscle and can be classified according to its characteristics, such as:
- Stage 1: Acute pain, small bleeding inside the joint and swelling. The symptoms worsen while performing movements with the arms but improve with the rest. This type usually affects young people;
- Stage 2: Pain remains constant and an ultrasound shows fibrosis with thickening of the subacromial bursa and tendinitis of the rotator cuff or biceps brachii. This type usually occurs between the ages of 25 and 40;
- Stage 3: Partial or total rupture of the rotator cuff or biceps brachii and is more common after the age of 40.
Tendon rupture can be treated with remedies and physiotherapy, and it is not necessary surgery immediately. Surgery is usually indicated when you present intense pain and major muscle weakness.
Symptoms of shoulder tendinitis
The main symptoms of shoulder tendinitis can be:
- Severe localized pain in the shoulder that may suddenly appear or worsen after exertion and tends to worsen at night due to muscle striation while you sleep;
- Difficulty raising your arm above shoulder line;
- Feeling that the pain has spread all over the arm and
- Tingling sensation may also be present, although it is rare.
When the tendinitis is localized in the biceps, the pain in the front of the shoulder and you feel pain when making movements above your head line and when you stretch your arm forward. When you have tendinitis of the rotator cuff, which is composed of the biceps, subscapular and supraspinous tendons, you feel pain in the anterior and lateral region of the shoulder, which worsens when you try to move your arm above head line and you may even have difficulty in elevating your arm to pass deodorant, for example.
Shoulder tendinitis treatment
The treatment is very important to eliminate pain and to allow you to do your daily tasks related to work or sports, and also helps to prevent tendon rupture, which may cause pain and swelling near the elbow. Treatment can be done with:
Physiotherapy is very important and can be done with ice packs, 3 or 4 times a day. It is also indicated devices that facilitate recovery like ultrasound and laser, as well as techniques to increase the range of movements, without pain, such as joint decompression, and pendulum and strengthening exercises to maintain the movement and strength of the affected limb.
Recovery time varies greatly from one individual to another, but at least 3 months of physiotherapeutic treatment is recommended.
The orthopedist may also indicate anti-inflammatory drugs, such as ibuprofen, which can be used to decrease pain and inflammation, and apply an anti-inflammatory ointment, such as Cataflan, throughout the shoulder. In the most severe cases, if even after starting physiotherapy pain does not improve, the doctor may indicate a corticoid injection directly into the shoulder, which has a stronger analgesic and anti-inflammatory action.
Acupuncture can also be used for shoulder pain relief, and can be done once a week. This type of treatment is a good complement and can bring relief of symptoms on the same day, but does not substitute the need for clinical and physiotherapeutic treatment because they complement each other.
Shoulder tendinitis surgery is indicated when, after 6 months to 1 year of continued treatments, with remedies and physiotherapy, sufficient movements are not restored. Surgery is also indicated when there is tendon rupture, pain and significant muscle weakness. However in many cases tendon rupture in people over the age of 60 can also be treated with medicines and physical therapy, and so it is up to the doctor to make this decision.
What can cause shoulder tendinitis
The most common causes of shoulder tendinitis are intense and repetitive strain on the arm or even staying for long periods with a poor posture, such as sleeping all night long with your head resting on your arm.
In this position tendons of the shoulder become more striated and the anatomy of the bones can interfere, because in some people the acromion may be more like a 'hook', which ends up harming the tendon.
The use of repetitive movements, such as in a volleyball game, for example, can generate enough stress on the shoulder, causing this type of tendinitis.
Generally, this tendon is injured by lifting your arms excessively during certain sports or professional activities, which favors the appearance of this impact syndrome. This can also occur during other activities such as swimming, tennis and professions such as carpenters, teachers and painters. These professionals are the ones that most commonly suffer from this type of tendinitis.