A rotator cuff (muscles and tendons in the shoulder) injury can range from minor irritation to a full-thickness tear. The injury can be caused by a sudden traumatic event, such as a fall or accident, or by repetitive wear and tear activities, such as throwing a baseball or working with items above the head. The treatments can range from home remedies to major surgery.
The simplest treatment is to avoid the movements and actions that cause pain. The Mayo Clinic recommends avoiding the repetitive actions that seem to be creating the shoulder pain for four to seven days to see if it improves.
Ice and Heat
Applying ice and heat for shoulder pain can be helpful. The ice packs help to decrease the inflammation and pain. The Mayo Clinic recommends applying either a cold pack, a bag of frozen vegetables, or an ice-filled towel to the shoulder area for 15 to 20 minutes. This ice can be applied every other hour for the first day or two. After that, a heating pad or hot packs can be applied to ease tightened and sore muscles. The heat applications should be limited to 20 minutes at a time.
Over-the-counter non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, or naproxen) can be used to help ease pain and inflammation. Acetaminophen can also be taken to ease the pain. A patient should follow the label instructions for the appropriate dosage.
After several days of using rest, ice/heat applications, or pain relievers, a patient can begin gentle exercises. While avoiding the movements that create the pain can help, total inactivity leads to stiff joints. Exercise or physical therapy help keep the muscles loose and limber. Daily stretches and exercises to strengthen the shoulder can keep an injury from recurring.
If the pain is severe and does not respond to simpler treatments, a doctor might treat the injury with a steroid injection to ease the inflammation and pain. For some patients the steroid injection provides enough relief so that physical therapy can be done.
If there is a large tear in the rotator cuff, surgery might be needed. A doctor can perform either an open repair, which requires a 2 ½-inch to 4-inch incision; a mini-open repair, which requires a 1 ¼-inch to 2-inch incision; or an arthroscopic repair, which requires multiple tiny incisions and arthroscopic technology. In surgery, the doctor repairs the tear and removes any bone spurs that might be present. The mini-open repair and the arthroscopic repair are usually done on an outpatient basis. The American Academy of Orthopaedic Surgeons reports that the mini-open repair is the most commonly used way to repair a torn rotator cuff and that its results are equal to an open repair.
In cases where the rotator cuff has been torn for a long time, a condition called rotator arthropathy can develop. The symptoms can include severe arthritis. In this situation, a doctor might recommend a more extensive surgery called arthroplasty, which involves a shoulder replacement.
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