Pain in shoulder is common medical problem in orthopedic practice. Shoulder joint is an important joint which facilitates easy maneuver of upper arm while performing various daily activities. Shoulder tendonitis is inflammation of rotator cuff tendon. A tendon is an end part of muscle which attaches the muscle to the bone.
Overuse and stress to the rotator cuff tendon can cause microscopic tears and inflammation of the tendon fibers leading to a condition called shoulder tendonitis. This condition is common in sports activities which require the arm to be moved above the head repeatedly.
Usually shoulder tendonitis is gradual in onset. In majority of cases the condition heals with conservative management.
What Causes Tendonitis Of The Shoulder?
Inflammation of rotator cuff tendon causes shoulder tendonitis. Shoulder joint is made up of three bones namely the head of humerus, acromion process of scapula (shoulder blade), and end of clavicle (collar bone). Rotator cuff tendon helps to keep the shoulder stable and the muscles helps the shoulder to rotate.
Shoulder tendonitis occurs over a period of time, it is gradual. Repeated microscopic trauma to the tendon causes inflammation of the tendon. The inflamed tendon is compressed by the surrounding structures mainly by the acromion bone of shoulder blade, leading to shoulder tendonitis.
Shoulder tendonitis is common among people playing certain sports which require the arm to be extended over the head repeatedly. These types of sport activities are basketball, tennis, badminton, weightlifting, swimming etc.
Repeated hyper-extension of arm over the head causes stress and microscopic tear to the fiber of rotator cuff tendon. It leads to inflammation and swelling of the tendon. The inflamed tendon may get trapped under the acromion bone giving rise to pain on shoulder movement, especially rotator movement.
Shoulder tendonitis may also develop if you sleep on one shoulder constantly every night. In some cases the cause remains unknown even after thorough medical history and evaluation.
Symptoms Of Shoulder Tendonitis
Pain in shoulder, especially in front side of arm is the primary symptom of shoulder tendonitis. In the beginning, pain is moderate but over a period of time, it become worse. Patient is unable to lift his arm above the head due to pain. There is clicking sound when he lifts his arm above the head.
Together with pain, the shoulder joint becomes stiff. At later stage pain is constant even during night time while sleeping. Patient also complains of accompanying weakness of the shoulder with pain. It becomes difficult for the patient to flex his arm behind the back due to pain and weakness.
Home Remedies To Treat Shoulder Tendonitis
Shoulder tendonitis is easily managed with conservative therapy. Initial treatment is to relieve the patient from pain and swelling in the shoulder. Once pain is relieved the other criteria of treatment is to restore the function of shoulder. Physical therapy promotes full restoration of function over a period of time.
In order to diagnose the condition the doctor may take detailed medical history and examine the patient. He may recommend doing certain imaging tests such as MRI and X-ray of shoulder.
Treatment consists of:
- Rest the affected shoulder for few weeks. Patient should avoid doing any type of work which requires lifting his arm above the head. He should restrict moving his arm vigorously. Rest helps the damaged tendon to heal fast.
- Ice fomentation initially for two to three days will reduce swelling and pain.
- Anti inflammatory medicines will also reduce pain and swelling. However, patient should restrict his activities with the affected arm even if the pain has reduced.
- Few week later physical therapy exercises as recommended by the doctor should be started. The main purpose of physical exercise is to strengthen the tendon and improve the range of motion.
- In some cases which do not show improvement, the doctor may recommend steroid injection to alleviate pain and swelling.
Home care measures:
- Patient should avoid sleeping on the same side of shoulder every night.
- Avoid carrying a bag and heavy object on the affected shoulder.
- Avoid lifting the arm over the head.
- Alternative treatment such as acupuncture and acupressure are found effective in treating the condition.
- Home remedies such as ginger and pineapple are also beneficial in reducing pain and inflammation of shoulder tendonitis. Pineapple contains an enzyme bromelain which is found to soothe pain and swelling. Ginger is useful in relieving chronic pain.