Shoulder Tendonitis

shoulder-bursitisShoulder tendonitis is an inflammatory condition in which the tendons around the shoulder joint become irritated and inflamed. There are two main categories, each with a separate management: rotator cuff tendonitis and biceps tendonitis. The rotator cuff is a group of 4 tendons that surround the ball of the shoulder joint and assist with movements. Repetitive activity can cause irritation of one or more of these tendons resulting in pain in the shoulder and upper arm. Most patients describe a sharp pain in the upper/outer arm when lifting their arm overhead or trying to put on a jacket. Strength and motion are preserved, but painful. Initial treatment includes activity modification, anti-inflammatory medication and corticosteroid injection. Physical therapy is often helpful if the condition persists. In refractory cases, an MRI to make sure the tendons are not torn is helpful. Occasionally, surgery is required to remove the inflamed bursa and clean out the tendon inflammation. This is done as an outpatient procedure with minimally invasive arthroscopic techniques.

Biceps tendonitis is a condition in which the area surrounding the upper portion of the biceps tendon becomes irritated. Many cases develop suddenly after increasing activity while others develop slowly as a result of degenerative changes around the shoulder. Most patients describe a sharp pain in the upper/front part of the arm when lifting the arm out straight in front or with flexing the elbow against resistance. Motion is preserved, but painful. Initial treatment includes activity modification, anti-inflammatory medication and corticosteroid injection. If the condition persists physical therapy is typically helpful. In refractory cases, an MRI to evaluate the tendon is helpful. Occasionally, surgery is required to repair the tendon using a procedure called biceps tenodesis. This is done as an outpatient procedure with minimally invasive techniques.