Rotator-Cuff Related Pain

Damien Moore (Physiotherapist – Burnie)

What is it?

This is a very common shoulder condition that we at Coastal Physiotherapy see and can become more prevalent with age. The rotator cuff muscles (4 small muscles that provide stability to the ball and socket shoulder joint) and adjacent structures such as bursae are commonly implicated. In most cases this condition develops insidiously usually after an increase in load to the shoulder joint. Pain can be usually felt anywhere in the upper arm from the shoulder joint to the elbow, and can be felt with activities such as:

• arm elevation;
• reaching;
• quick unguarded movements;
• placing the arm under load;
• getting dressed / undressed;
• lying on the shoulder.

How long will it take to come right?

Recovery is usually slow and gradual with a timeframe of at least 3-6 months not uncommon with 70-80% of cases appropriately managed with conservative treatment (i.e. physiotherapy).

Do I need any investigations such as an X-ray or ultrasound?

Generally because of the atraumatic history of the condition, diagnostic investigations such as X-rays and ultrasounds are not usually required in the first instance. This is because they are likely to reveal findings that are equally prevalent in similarly aged people WITHOUT shoulder pain. Whether you need (or don’t need) further investigation can only be determined from a thorough initial physiotherapy assessment.

What can I do to help it?

• Reduce adverse loads through the shoulder but keep using the arm within its limitations such that strength, range of movement and function are maintained.
• Because 70-80% can be managed appropriately with conservative treatment, seek guidance from a physiotherapist on the best management moving forward which is usually a targeted strength program for the rotator cuff muscles.
• If high pain levels are experienced or if there is a regular disturbance of sleep, it may be feasible to consult your GP for appropriate pain-relief as well.

What other treatment options are available if physiotherapy is not helping?

• Sometimes cortisone injections are advocated however the benefit is usually small and short-term in the first 4-6 weeks after the injection.
• Referral to an orthopaedic surgeon is sometimes required for potential surgical intervention.

If you have shoulder pain that tends to come on with any of the activities listed above, your best option is to have it assessed by a Physiotherapist, either at our Burnie or Somerset clinic. Your Physiotherapist can help you get back to doing what you like without pain and restriction. For an appointment today call our Burnie clinic on 64314586.