Shoulder pain can interfere with routine activities and interrupt sleep.
If the pain continues for several days or is accompanied by shoulder weakness or the inability to raise your arm, contact your doctor to rule out a problem like a rotator cuff tear.
Allowing this condition to progress may make it more difficult to treat later.
The rotator cuff is a group of muscles surrounding the shoulder. Its two main functions are to initiate motion, such as raising your arm over your head or rotating your arm and to stabilize the ball, or humeral head, of your arm in the socket of your shoulder.
When those muscles are deficient or torn, your shoulder and arm will not function properly.
While we associate a "tear" with one traumatic event or injury, rotator cuff tears are more likely to be degenerative or the result of years of wear and tear.
They are common in both men and women especially over age 50.
When an orthopedic surgeon evaluates your shoulder, you likely will receive a corticosteroid (steroid) injection to relieve the pain and assist with your diagnosis. If weakness continues following the injection, your surgeon will suspect a rotator cuff tear and may order an MRI to confirm or disprove it.
Symptoms relieved with the injection can typically be treated with anti-inflammatory medications and physical therapy to strengthen the muscles and improve your range of motion.
If a tear is confirmed, you may require surgical rotator cuff repair.
Arthroscopic surgery, a minimally invasive technique, is used for rotator cuff repair surgery. During the outpatient procedure the surgeon makes a small incision to insert a small arthroscopic camera and look inside your shoulder.
The surgeon removes any bone spurs and inflammatory tissue, or bursitis, surrounding the muscles before inspecting the rotator cuff.
Special implants, or bioabsorbable anchors containing sutures, are screwed into the bone where the tendon is torn. The sutures are sewn through the tendon to allow reattachment of the torn tissue to the bone to correct the tear.
Post-surgical pain is managed with a nerve block, administered prior to the procedure, which allows you to transition more easily to oral pain medication. Ice and cold therapies also help reduce pain and swelling.
Patients typically go home on the day of surgery with their arm in a sling and a cryo, or cold therapy, unit. You may need to wear the sling for up to six weeks. Recovery time varies based on the size of the tear.
Physical therapy is a critical step in the recovery process and helps maximize the benefits of the rotator cuff repair procedure, which are reduced pain and increased strength and motion.
Delaying treatment for shoulder pain puts you at risk for additional and sometimes irreparable damage.
When the rotator cuff tear is too old and there is too much muscle loss, or the tendon has retracted or pulled too far away from the bone to reattach it, a more complicated surgery or reverse shoulder replacement may be required. These more invasive procedures require hospital admission, so it is important to contact your physician at the earliest stages of your shoulder pain.
Kuri recently joined the Susquehanna Health Orthopedics team. He specializes in treating all conditions affecting the shoulder, elbow and knee including sports medicine, trauma and degenerative conditions.