Shoulder Pain from Rotator Cuff Tear
Rotator cuff tear injuries are common in middle aged individuals. The prevalence of such injuries can be as high as 34% in the adult population. That is to say, the cause of a rotator cuff tear is likely multifactorial, with degeneration, impingement, and overload may all contribute in varying degrees to the development of rotator cuff tears.
Several theories have developed to explain the cause of rotator cuff injury:
- Intrinsic tissue degeneration- wear and tear of the actual tendon
- Hypovascularity leading to tendon degeneration- limited blood supply causing accelerated degeneration
- Impingement from external structures- compression of the tendon
- Tension overload injuries from sports or trauma- overuse or forceful injuries
For example supraspinatus muscle and tendon appears to be the most commonly involved. Injuries, otherwise reported as tears, may be partial or full thickness. Other muscles that may be involved include the infraspinatus, subscapularis and biceps tendons.
RISK factors include:
- Middle aged or older
- Sports
- Trauma
- Repetitive activities particularly overhead reaching
- Smoking
- Obesity
Moreover, there may also be a genetic and familial predisposition to these injuries.
SYMPTOMS
- Shoulder pain
- Weakness
- Lateral shoulder pain (pain on the outside of the shoulder)
- Pain in the shoulder that maybe worse at night
- Pain in the shoulder that is worsened with overhead reaching
However, these symptoms are rather vague and may represent many other possibilities. The pain experts and doctors at Carolinas Pain Center can help evaluate and differentiate this for you.
Other causes of shoulder pain can be:
- Shoulder pain from bursitis,
- Shoulder pain from impingement
- Shoulder pain that is referred due to cervical disc degeneration
- Cervical radiculopathy causing shoulder pain
- Referred pain from other areas
- Other muscular causes such as trigger points or tender points
PHYSICAL EXAM
In conclusion the providers and pain doctors at Carolinas Pain Center will examine your shoulder and perform various different movements of your shoulder to determine your cause of pain. Shoulder exam tests have varying levels of sensitivity and specificity to determine the cause of your pain. Ultimately, your Carolinas Pain Center provider will make a decision after reviewing everything.
IMAGING STUDIES
X-rays, MRI and Ultrasound can be utilized to evaluate your shoulder. Which test needs to be ordered depends on each individual situation.
TREATMENTS OFFERED AT CAROLINAS PAIN CENTER
Evaluation and recommendations for exercises that may help your pain
Physical therapy can help in addition to our exercises
Shoulder joint injections with ultrasound guidance
Shoulder bursa injections with ultrasound guidance
Nerve blocks (suprascapular and axillary nerve) to reduce pain in the shoulder
Radiofrequency ablation of nerves
Platelet Rich Plasma injections (PRP injections)
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