Shoulder tendonitis is inflammation of one of the shoulder tendons that can cause symptoms like pain, tingling, and difficulty lifting the arm overhead.
This type of condition can happen to anyone but is more common in people who participate in activities involving repetitive arm motions, such as swimming or painting.
People with symptoms of shoulder tendonitis should consult an orthopedic specialist or a physical therapist for an assessment. Treatment may involve medications, physical therapy, or, in the most severe cases, surgery.
Main symptoms
Symptoms of shoulder tendonitis include:
- Severe localized shoulder pain that can come on suddenly;
- Difficulty raising the arm above shoulder height;
- Pain that radiates through the whole arm;
- Tingling in the shoulder, in some cases.
Symptoms of shoulder tendonitis are caused by inflammation of the tendon due to repetitive movements and tend to worsen at night due to stretching of the muscles while sleeping.
These symptoms require an assessment by an orthopedic specialist or physical therapist to determine the most appropriate treatment in order to reduce inflammation and relieve symptoms.
Possible causes
The most common causes of shoulder tendonitis are intense and repetitive use of the arm or prolonged periods of poor posture, such as sleeping on your stomach all night with your arm under your head, as this position can stretch out the shoulder tendons.
The tendon may also become inflamed and injured due to excessive overhead arm movements that are part of activities like swimming, volleyball, and tennis. These movements are also common in professionals like carpenters, teachers, and painters.
Confirming a diagnosis
The diagnosis of shoulder tendonitis is made by an orthopedic specialist or physical therapist based on presenting symptoms and a physical exam. A provider may also recommend imaging tests like an ultrasound or MRI (magnetic resonance imaging) to confirm the diagnosis.
Stages of tendonitis
In some cases, a provider may order imaging tests to determine the stage of tendonitis. These include:
- Stage 1: Acute pain, small amount of bleeding in the joint, and swelling. Symptoms worsen with movement of the arm and improve with rest. Typically affects young people;
- Stage 2: Pain is constant and ultrasound shows evidence of fibrosis with thickening of the subacromial bursa and tendonitis of the rotator cuff or biceps brachialis. More common in people between 25 and 40 years of age;
- Stage 3: Increased risk for partial or total rupture of the rotator cuff or biceps brachialis. More common after age 40.
Identifying the stage of tendonitis can help a doctor or physical therapist determine the most appropriate treatment. People at every stage should avoid moving the affected shoulder for a specified amount of time to help speed up recovery.
Treatment options
Treatment of shoulder tendonitis focuses on reducing inflammation of the shoulder tendon, alleviating symptoms, restoring the ability to perform daily activities without pain, and preventing tendon rupture.
1. Medications
An orthopedic specialist may prescribe medications like anti-inflammatories to help relieve pain and inflammation. Anti-inflammatory ointments may also be recommended to be applied over the entire shoulder.
In the most severe cases, a doctor may recommend injecting corticosteroids directly into the shoulder, which have a stronger analgesic and anti-inflammatory effect. This is typically reserved for cases in which there is no improvement in pain even after starting physical therapy.
2. Physical therapy
Physical therapy is essential for the treatment of shoulder tendonitis to help alleviate symptoms by reducing inflammation and strengthening the joint. A physical therapist may use techniques like TENS, ultrasound therapy, and laser therapy in addition to exercises to increase range of motion and strengthen the shoulder.
Recovery time varies from person to person but typically requires three months of physical therapy to perform the movements without pain or discomfort.
3. Surgery
Surgery for shoulder tendonitis is indicated when 6 to 12 months of conservative treatment with medications and physical therapy are not enough to reestablish movement to a satisfactory degree.
Surgery may also be recommended in cases of tendon rupture, pain, and significant muscle weakness. In many cases, however, a tendon rupture in people over 60 can also be treated with just medication and physical therapy. The decision to have surgery should be made after consulting with an orthopedic surgeon.
Also recommended: Tendonitis Treatment: 6 Treatment Approaches (& How to Prevent) tuasaude.com/en/tendonitis-treatmentRecovery time
Recovery time can vary greatly from person to person based on severity, age, and adherence to treatment. On average, at least three months of treatment are necessary to restore mobility.