Rotator cuff problems

Feeling pain in your shoulder when you lift your arm over your head may mean you have a have a problem with your rotator cuff.

So, what causes rotator cuff problems?

The rotator cuff is a group of muscles and tendons that attach to the bones of your shoulder joint. The group allows your shoulder to move and keeps it stable. Pain in your rotator cuff area usually means you have rotator cuff tendinitis, or inflammation of these tendons and inflammation of the bursa, (smooth slippery sacs the tendons glide across); or a rotator cuff tear, when one the tendons is torn from overuse or injury.

Rotator cuff tendinitis may be due to keeping your arm in the same position for long periods of time, such as doing computer work or hairstyling. Sleeping on the same arm each night can also cause this problem. You can also get tendinitis playing sports that require you to move your arm over your head repeatedly, such as in tennis, baseball (especially pitching), swimming, and weight-lifting.

Rotator cuff tears may happen if you fall on your arm while it is stretched out, or after a sudden, jerking motion when trying to lift something heavy. Chronic tears occur slowly over time, particularly in people who have chronic tendinitis. At some point, the tendon wears down and starts to tear.

If you have tendinitis, you'll have pain when you lift your arm over your head, such as when you brush your hair and reach for objects on shelves. The pain may be mild at first, but over time you may have pain at rest or at night, especially when you lie on your shoulder.

The pain of a sudden rotator cuff tear can be intense. Your shoulder may be weak, and you may hear a snapping sound when you move your shoulder. Chronic symptoms include a gradual worsening of pain, weakness, stiffness or loss of motion. Most people with rotator cuff tears have worse pain at night and when they wake up.

To treat your rotator cuff problem, your doctor will check your shoulder for tenderness and lift your arm to see in which position you have pain. X-rays may show a bone spur (a bony projection). If your doctor thinks you have a tear, you may have an ultrasound or MRI.

Treatment for rotator cuff tendinitis involves resting your shoulder and avoiding the activities that cause you pain. You can also try applying ice packs 20 minutes at a time, 3 or 4 times a day. Medicines like ibuprofen may help reduce swelling and inflammation. Eventually, you should start physical therapy to learn to stretch and strengthen the muscles of your shoulder. Surgery can remove inflamed tissue and part of the bone that lies over the rotator cuff, which may help relieve the pressure on your tendons.

Someone with a partial rotator cuff tear can try rest and exercise, if they don't normally put a lot of demand on their shoulder. But if there's a complete tear, or if the symptoms don't improve with therapy, you may need surgery to repair the tendon.

But with rest or exercise, symptoms of most shoulder problems often improve or go away, though it may take months.