How to Diagnose Rotator Cuff Tendinitis
Tendinitis is a painful inflammation of a tendon, usually requiring rest, sometimes requiring surgery. When it occurs in the rotator cuff--a supporting structure for the shoulder joint that includes muscles and tendons--it is not only painful, it is also sometimes tricky to diagnose. Tendinitis of the rotator cuff can be mistaken for other injuries or conditions.
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Instructions
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Locate the rotator cuff. This is found at the top part of the arm bone where it forms a joint with the shoulder blade. According to the National Library of Medicine, the symptoms of rotator cuff tendinitis are: pain associated with arm movement; pain in the shoulder at night, especially when lying on the affected shoulder; weakness with raising the arm above the head, or pain with overhead activities (brushing hair, reaching for objects on shelves).
If the pain is associated with raising the arm to the side, especially when combined with a forward motion, it is likely a rotator cuff problem.
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Consider other causes. Tendinitis differs from other problems in that the pain usually comes on gradually. It begins over the upper arm and the side of the shoulder. Other problems that may be mistaken for tendinitis of the rotator cuff, and how they differ from tendonitis, include:
Bursitis: Inflammation of the bursa sac between the shoulder joint and rotator cuff tendons; may be combined with tendinitis. Both are inflammation of soft tissues in the shoulder. Treatment options are the same as for tendinitis.
Muscle strain: Pain may come on suddenly, but is relatively mild. Recovery time with rest may be as little as two weeks--a good deal shorter than that for tendinitis.
Acute tear: Pain is sudden and throughout the arm, right at the time of injury.
Chronic tear: Very similar to tendinitis, although the sufferer may have no symptoms; the pain may come on gradually and may worsen until the arm cannot be lifted. Treatment options are similar to those for tendinitis (Tearing of the tendon may result from untreated tendinitis).
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Consider your activities. As with most types of tendinitis, the inflammation is usually caused by overuse, particularly when problems arise in younger people. Rotator cuff tendinitis is often associated with baseball pitchers, but other sports like tennis, weight lifting and rowing, and jobs that require similar movement, such as house painting, may also lead to overuse and injury. Other risk factors include weak shoulder muscles, advancing age and poor posture.
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See your health-care provider. Doctors are usually able to diagnose tendinitis from a description of the symptoms. The doctor may also stretch out the arm or have you move it to find out what circumstances cause the pain and how severe it is. If there is doubt as to the cause of the pain, the doctor may request an x-ray to see if the bones are injured or have spurs that might be an underlying cause of injury. If that does not confirm tendinitis, an ultrasound or an MRI may be performed to provide an image of the shoulder. Generally, however, tests like these are not required to make a good diagnosis.
Treatment recommendations may include stretching the shoulder, anti-inflammatory drugs, icing, steroid injections, physical therapy, use of a sling or, in the worst cases, surgery--even shoulder replacement. Be sure to follow the advice of your health-care provider, especially to be patient with the healing process. Rushing to get back on the mound is an invitation to worse injury.
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Tips & Warnings
Consult your doctor to confirm the diagnosis and determine a course of treatment.
