Shoulder tendonitis can be quite disabling. What are the symptoms of shoulder tendonitis and how is it treated? The rotator cuff muscles is the name for four deeper shoulder muscles that are largely responsible for the mobility of the arm and whose tendons surround the shoulder head like a cuff. These tendons are quite sensitive to inflammation because they are clamped against the lower edge of the shoulder blade. Tendonitis or tendinitis is caused by overload or microtrauma and is often accompanied by bursitis, an inflammation of the bursa, which lies between the tendon and the shoulder blade, or by tendovaginitis, an inflammatory reaction of the sheath that covers a tendon.
- What is tendonitis?
- Causes of tendonitis in the shoulder
- Symptoms
- Examination and diagnosis
- Treatment of tendonitis in the shoulder
- Physiotherapy and medication
- Local infiltration in shoulder tendonitis (injection)
What is tendonitis?
A tendon (tendo) is a tough, non-contractible end of a muscle. A tendon is a solid, white-shiny structure that connects a muscle and a bone. Muscle activity can be transmitted to the bone via the tendon. With tendonitis in the shoulder, several micro tears occur in this tendon, which can cause sudden onset of pain in the shoulder and pain during shoulder movements at the place where the tendon is attached to the bone. These complaints can be so annoying that they are experienced as disabling.
Causes of tendonitis in the shoulder
Tendonitis in the shoulder can occur because you either move too much (overload) or move too little (underload/inactivity). Lack of exercise weakens muscles, tendons and joints, making it easier for inflammation to develop. Tendonitis in the shoulder is usually caused by microscopic tears in the tendon, sustained by a (sports) injury or overuse. It can be a one-off sudden overload (for example, frequent movements of the shoulder above the head causing the ceilings in the house to hurtle) or long-term, chronic overload (this is common in some professions and sports where the shoulder is often lifted high). . The last form of overload has a less favorable prognosis; recovery often takes longer. Tendonitis in the shoulder can also be caused by rheumatic diseases (arthrosis is the most common rheumatic disease of the musculoskeletal system) or an accident. The risk of tendonitis in the shoulder increases with age because the tendon tissue deteriorates in quality over time.
Pain in shoulder / Source: Istock.com/AndreyPopov
Symptoms
Tendonitis in the shoulder can cause the following shoulder complaints:
- pain in the upper shoulder, especially at night;
- shoulder limitation (the degree of limitation depends on the severity of the tendonitis);
- Pain may radiate from the shoulder to the entire upper arm.
The complaints of tendonitis can often be treated well with timely and adequate treatment.
Examination and diagnosis
The diagnosis can be made through physical examination, x-rays and ultrasound. The quality of the bone in the shoulder can be visualized using X-rays. And an ultrasound can be used to see whether there is fluid in the tendon or bursa. In this way, it can be investigated whether the complaints are related to a tendon tear, osteoarthritis or calcifications. (In osteoarthritis, the cartilage changes, causing complaints such as stiffness and joint pain.) With tendonitis, calcium deposits can form. This means that calcium is deposited in the tendons as a result of long-term irritation. This is also called ‘tendinitis calcarea’ (tendon calcification).
Treatment of tendonitis in the shoulder
Physiotherapy and medication
Sometimes you can get rid of the inflammation by keeping relative rest and monitoring how the complaints develop. It’s about relative rest: it is essential to keep moving, keeping a close eye on your limits and not overloading the shoulder. Sometimes physiotherapy is required. The GP can also prescribe medication. Most patients can get the symptoms of tendonitis under control with exercises given to them by the physiotherapist and by taking anti-inflammatories.
Local infiltration in shoulder tendonitis (injection)
Occasionally local infiltration is necessary. An injection is given into the joint with an analgesic and an adrenal cortex hormone (corticosteroids). This has an anti-inflammatory effect. This treatment lasts approximately six weeks. Such an injection may be given three to four times a year (if it appears to have an effect). Such an injection rarely causes side effects. If this does not provide sufficient relief, surgery is an option. This does not happen relatively often.
read more
- Tendonitis: tendinitis in the shoulder, wrist, knee or thigh
- Pain in shoulder, arm and neck: tendon & bursitis
- Shoulder pain: nagging or stabbing shoulder pain
- Shoulder pain: symptoms and causes of shoulder pain
