Non-surgical management of rotator cuff tendonitis, called impingement syndrome
The most common cause of shoulder pain in this country is impingement syndrome, also known as rotator cuff tendonitis. Impingement syndrome is a term that means impingement of the soft tissue between the shoulder area called the acromion and the rotator cuff musculature. The area that gets pinched when you lift or rotate your arm is called a bursa. A bursa is a term for a piece of soft tissue that lines the muscles and provides cushioning, protection, and lubrication. The rotator cuff bursa develops into bursitis due to soft tissue inflammation from repetitive activity.
This repetitive activity can be something like weightlifting, golf, tennis, really any activity that involves repetitive weightlifting and rotation of the shoulder in such a way that the bursal sac is repeatedly pinched against the bone called the acromion. The good news with impingement syndrome is that more than 90% of the time, conservative treatments work and the pain improves without surgery.
Conservative treatments for impingement syndrome include:
- Benign Neglect – It is not a fatal condition, you can simply neglect it and deal with the discomfort.
- steroid injections
- Physical therapy
- Alternative treatments – Chiropractic and/or acupuncture
- Pain medications such as Tylenol, NSAIDs, or short-term narcotics for severe pain
The good news is that these conservative treatments usually work very well and the patient’s pain is controlled.
Using medication over a chronic period of time is not a good option for impingement syndrome. They can become addictive, and the pain of rotator cuff tendinitis is simply not worth chronic narcotics.
Should surgery be necessary, and again this is less than 10% of the time, the procedure is called an arthroscopy. The procedure is usually quite short, an hour or less, and involves shaving off a piece of bone below the acromion to give the person more clearance as the shoulder elevates and rotates during activities.
So, in summary, the good news is that rotator cuff tendonitis, which is often called impingement syndrome, is a condition that can generally be treated non-surgically very effectively.