Rotator Cuff Tendonitis

Illustration of the rotator cuff

Key Points

Rotator cuff tendonitis is inflammation of the rotator cuff muscles.
The chronic form is termed rotator cuff tendinosis/ tendinopathy
Most patients will have lateral shoulder pain, worse with overhead activity
Treatment involves activity reduction, physical therapy and medications
Corticosteroid injections can be used as a second line option

Condition

Rotator cuff tendonitis occurs when there is inflammation in the four muscles that make up the ‘rotator cuff’. This is associated with repetitive overhead activities (throwing, raking, washing cars, etc). It can also occur as a result of an injury. Rotator cuff tendonitis is the most common cause of shoulder pain in all age groups. Rotator cuff tendonitis is the mildest form of rotator cuff injury. The more chronic form is called rotator cuff tendinosis or tendinopathy.

Symptoms

Classically, this presents as a dull aching pain on the outside of the shoulder. Usually, there is no preceding trauma. It may radiate up into the neck or down the arm and is worse with lifting or overhead activities. Patients are most commonly tender on the outside of the shoulder. The doctor has special tests they can perform to provoke the pain and help confirm the diagnosis.

Treatment

Most rotator cuff tendonitis will get better without surgery. First line therapy includes cutting back on offending activities, non-opiate pain medications and physical therapy. Physical therapy is probably the most important treatment and can often be performed at home. Sometimes, corticosteroid injections are used. Patients can also consider massage therapy and acupuncture. Rarely, surgery is used to treat rotator cuff tendonitis.