The shoulder joint is made up of three bones (humerus, scapula and clavicle), with the arm kept in the shoulder socket by the rotator cuff. These muscles and tendons form a cover around the head of the upper arm bone and attach it to the shoulder blade. The bursa is a lubricating sac that allows the cuff tendons to glide freely when you move your arm.
The rotator cuff is a common source of shoulder pain and can be the result of:
- Tendinitis which is when the cuff tendons become irritated or damaged
- Bursitis where the bursa becomes inflamed
- Impingement when the space between the acromion and rotator cuff narrows, which can result in acromion impinging (rubbing) on the tendon and bursa
Pain generally is associated with this condition, along with some swelling and tenderness in the front of the shoulder, with associated stiffness when lifting the arm. In the beginning, symptoms may only be mild however as the problem progresses these increase and can cause pain at night; a loss of strength and range of motion as well as difficulties in doing certain activities that place arm behind back.
Non-surgical treatment is usually the first line of treatment and can take several weeks to months with gradual improvement and return to full function. Non-surgical modalities include; rest, anti-inflammatory medication, physiotherapy and steroid injections.
If non-surgical measures do not improve function, surgery may be offered, with the aim of surgery being to create more space for the rotator cuff. This surgery can be performed using either an arthroscopic or open technique. Following any surgery, a rehabilitation program will be provided to regain range of motion and strength in the shoulder and arm.
It can take typically two to four months for complete relief of pain, but may take up to a year for full recovery.