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Shoulder Tendinitis – Inflammation of the Tendon

About Tendinitis

A tendon is a thick fibrous cord that attaches the muscle to the bone in the human body. Tendinitis or Tendonitis is the inflammation or irritation of the tendon. Repetitive activities of the thumb, elbow, shoulder, hip, knee, and the achilles tendon, lead to this condition.

About Shoulder Tendinitis

The shoulder consists mainly of three parts – the humerus, the tendons of the rotator cuff, and the bursa. These three parts move through an archway called the coracoacromial arch. During a shoulder movement, this archway condenses and in turn compresses the tendons and bursa. Overuse of the arms and shoulder leads to damage of the tendons of the rotator cuff, medically termed as Shoulder Tendinitis.

A common condition with sports persons, Shoulder Tendinitis may affect other people too, especially those involved in repetitive activities, such as gardening, carpentry, raking, shoveling, and more. The patient usually experiences pain at the tip of the shoulder that gradually spreads to the arm and it increases when the he lifts or twists his arm.

Causes

The common causes of inflammation or irritation of a tendon of the shoulder include:

  1. Injuries
  2. Overuse of the joint
  3. Incorrect posture
  4. Infection
  5. Effect of other diseases, such as Arthritis, Gout, and more
  6. An abnormal or poorly placed bone or joint
  7. Non-indulgence in stretching exercises before playing sports
  8. Age; with increase in age the tendons of the human body become weak and less flexible, making people above the age of 40, more prone to Tendinitis
  9. Sports, especially baseball, basketball, golf, tennis, and more
  10. Sleeping on the shoulder for many consecutive nights

Signs and Symptoms

Pain, swelling, tenderness, and difficulty in moving the shoulder are the main symptoms of Tendinitis.

Consultation

A General Physician or an Orthopedic Surgeon is the subject matter expert.

Types of Shoulder Tendinitis

The four types of Tendinitis are:

  1. Overuse Tendinitis: Repetitive straining of the rotator cuff leads to weakening of the joint and results in pain. Various sports activities are the main cause of Overuse Tendinitis.
  2. Calcific Tendinitis: At times, when inflammation of the tendons persists for a long period, it results in Calcium deposits, medically known as Calcific Tendinitis.
  3. Impingement Tendinitis: A weak rotator cuff, swollen bursa, or bone spur may lead to narrowing of the space between the coracoacromial arch and the rotator cuff resulting in the humerus forcing the rotator cuff tendon to intrude into the arch. This condition, called Impingement Tendinitis, causes extreme pain, and usually occurs due to repetitive use of the shoulder.
  4. Rotator Cuff Tear: Injuries, long-term impingement, and degeneration are a few of the causes of rotator cuff tears. This type of Tendinitis results in extreme pain, weakness, and loss of normal movement.

Tests and Investigations

Imaging tests, such as X-Rays, Magnetic Resonance Imaging (MRI), and Ultrasounds are the best ways to confirm Tendinitis. An X-Ray may rule out chances of a Bone Spur, and an MRI or Ultrasound checks extent of damage of the tendon.

Treatment Modalities Available

Managing the pain and swelling are the two main challenges of Tendinitis treatment. The treatment modalities available include:

  1. Self-Care: Taking painkillers, avoiding activities that cause pain and applying cold packs to the shoulder three to four times a day, helps combat Tendinitis. However, if the condition does not improve, a visit to a medical practitioner is inevitable.
  2. Oral Medication: Taking non-steroidal anti-inflammatory medications (NSAIDs) like Ibuprofen & Naproxen, helps reduce the pain and swelling.
  3. Corticosteroid Injections: In case of extreme & unbearable pain that does not subside with oral medication, doctors prescribe Corticosteroid Injections. Corticosteroid medicines contain steroid hormones that help in reducing inflammation instantly.
  4. Physiotherapy: Regular sessions of Physiotherapy, under a Physiotherapist’s guidance, help the patient to get back to normal activities.
  5. Extracorporeal Shock Wave Therapy (ESWT): When the above treatments fail, doctors suggest Extracorporeal Shock Wave Therapy thatinvolves passing of shock waves through the skin to the affected area.
  6. Surgery: When none of the above measures work, the physicians recommend a Surgery. Though rarely suggested, the two important types of surgeries are Calcific Tendonitis and Biceps Tendonitis. Calcific Tendonitis involves an Arthroscopy, which is a minimally invasive surgery to remove calcium deposits on the tendons of the shoulder. Biceps Tendonitis is a surgery performed to repair a torn tendon.

Complication in Management

Taking proper medication and performing exercises under a Physiotherapist’s supervision, prevents the condition to deteriorate. Following the correct treatment procedure helps in fast recuperation.

Precautions during Treatment

Taking the following precautions helps in a quick recovery:

  1. Use a good posture while sitting
  2. Avoid lifting arms repetitively over the head
  3. Avoid repetitive activities
  4. Do not sleep on the same side every night
  5. Do not carry a bag only on one shoulder or objects close to the body

Physical Activity Requirements during the Course of the Treatment

The important physical activity requirements during the course of the treatment include maintaining a good posture, putting the shoulder to rest, and indulging in exercises as per the physiotherapist’s advice.

Prevention to Avoid Recurrence

Adopting the following measures helps in avoiding recurrence of Tendinitis.

  1. Avoid prolonged stressful activities which put strain on the tendons.
  2. Indulge in exercises under a professional trainer’s supervision. Stretch before and after the exercise schedule. This helps to reduce repetitive Micro Trauma on tight tissues.
  3. Sit in a correct posture.
  4. On the slightest sign of pain, take rest.

Support from Family

Constant support and assurance from the family members helps in improving the physical & psychological health of the patient.