Understanding shoulder pain and treatment options

While some may assume that rotator cuff injuries are most prevalent among athletes, shoulder pain is quite common among individuals after age 50 – and rotator cuff issues are the most frequent cause.

Sometimes rotator cuff pain is the result of an acute injury, but most shoulder pain is a natural part of the aging process. As we age, our tendons deteriorate. The rotator cuff is particularly susceptible to wear and tear over time and can be hastened by a person’s profession or an active lifestyle. Reaching for an object can trigger the first onset of shoulder pain.

The range of issues causing shoulder pain

If you’re suffering from shoulder pain, we would assess both your range of motion and the strength of your rotator cuff. The continuum of causes of shoulder pain includes tendonitis resulting from mild wear and tear of the tendons in the shoulder to partial tears in the tendon to very large tears where a portion of the tendon is detached from the bone.

Treatment options

The treatment options vary by the severity of the cause of the shoulder pain. For the milder cases, we usually start with physical therapy or a guided home exercise program, often coupled with anti-inflammatory options to help manage the pain. Anti-inflammatory medications can be oral or topical, or a cortisone injection.
If pain persists, an MRI is usually ordered to help evaluate the rotator cuff. If the MRI shows only minimal or mild pathology, we’ll look at additional non-surgical options and greater diligence in the performance of those treatments. If, on the other hand, the images indicate a full thickness tear or a larger tear, we are likely to recommend surgical treatment.

Good news, bad news for rotator cuff surgery

The good news about rotator cuff surgery is that it is typically performed as an outpatient – as a minimally invasive procedure and there is a good prognosis for a full recovery. In addition, the repair is protected by immobilizing the arm in a sling for the first several weeks. The patient is then provided with a detailed and guided physical therapy program to gradually restore range of motion and strength.
The bad news for the patient is that recovery can take some time – it takes at least three months for the repair to fully heal.

Additionally, if you have a more severe issue, like a long-standing, massive tear, we do have more advanced surgical alternatives than we used to have available.

In conclusion

Years ago, when patients had rotator cuff tears, there was little we could do beyond managing their pain with medications and injections. Today, we have many more options to help patients manage or resolve shoulder pain and rotator cuff injuries or deterioration. If you’re suffering from shoulder pain and would like to learn more, call (574) 534-2548 to schedule an appointment.