Impingement syndrome, Subacromial bursitis, bicipital tendinitis and rotator cuff tendinitis, supraspinatus tendinitis
These shoulder problems are related to each other and mostly occur in combination, with shoulder tendinitis leading to an impingement syndrome. If the muscles and tendons of the rotator cuff or the bursa of the shoulder are injured, they become inflamed, and swollen. Repeated motion involving the arms or motion over many years may also irritate the tendons, muscles, and surrounding tissue. Tendinitis is inflammation (redness, soreness, and swelling) of a tendon. Tendinitis of the shoulder is the condition in which the tendons of the rotator cuff or the tendons of the biceps become inflamed and irritated. This injury can be mild or severe. When the rotator cuff tendon becomes inflamed and thickened, it may get trapped under the acromion (the top of the shoulder blade). This is called impingement syndrome. When there is inflammation of the fluid-filled sac called the bursa bursitis of the shoulder occurs.
- Slow onset of pain in the upper shoulder or upper arm
- Difficulty sleeping on the shoulder.
- Tendinitis and bursitis also cause pain when the arm is lifted away from the body or overhead.
- If tendinitis involves the biceps tendon (the tendon located in front of the shoulder that helps bend the elbow and turn the forearm), pain in the front or side of the shoulder is common and may travel down to the elbow and forearm.
Sportspersons who overuse the shoulder and occupations requiring frequent overhead reaching are other potential causes of irritation to the rotator cuff or bursa and may lead to inflammation and impingement.
Treatment includes rest, ice, and anti-inflammatory medicines. In some cases physical therapy is prescribed. Gentle stretching and strengthening exercises are added.
If there is no improvement after 6 to 12 months of physical therapy and medications, arthroscopic surgery may be used to repair damage and relieve pressure on the tendons and bursae. Here the soft tissues and the bony spur are shaved to create space.