Cuff Tendinopathy of the Shoulder

What is cuff tendinopathy of the Shoulder?

This is a condition that causes pain over the shoulder. It is due to the rotator cuff, a group of muscles that control shoulder movements, especially supraspinatus, being damaged. The condition can arise alone or can be associated with shoulder impingement. The latter occurs when bony outgrowths dig into the rotator cuff tendons causing pain. Calcium deposits can also occur in the tendons. In somecases the condition can be very painful.

How is it diagnosed?

Diagnosis by a specialist is usually straightforward, and X-rays are usually may be performed to show the deposits of calcium and to confirm the diagnosis. In some cases an ultrasound scan may be performed to confirm the diagnosis and to exclude a rotator cuff tear.

How is tendinopathy of the Shoulder Treated?

Treatment starts with simple measures, and these are often effective. Anti-inflammatory tablets and painkillers can help symptoms. Physiotherapy exercises are important in preventing the shoulder becoming stiff through restricted use because of the pain. Muscle strengthening, usually under the guidance of a physiotherapist can also help. Avoiding repetitive movements and correct warming-up and stretching techniques can also help.

What if these don’t help?

Sometimes the condition does not respond to these simple measures and the pain becomes longstanding (chronic). In these cases other treatments are considered.

Shock wave therapy is the most effective next step if simple measure do not help as it is often successful and is non-invasive (no needles or surgery) being performed in the outpatient clinic without the need for any anaesthetic. It is also very safe. Our results show that 70% of people with Calcific Tendinopathy are successfully treated.

Sometimes the condition occurs very suddenly and is excruciatingly painful (acute calcific tendinopathy) and a large deposit of calcium occurs in the tendon. In these cases needling is performed under a brief general anaesthetic or sometimes under local anaesthetic with sedation. It involves directing a needle into the calcium deposit and trying to aspirate (suck) it out to relieve the pain.

Excision of the deposit is a procedure performed under general anaesthetic usually through key-hole surgery.

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