Rotator cuff disease

Damage to the rotator cuff that can be due to trauma, as from falling and injuring the shoulder; overuse in sports, particularly those that involve repetitive overhead motions; inflammation, as from tendonitis, bursitis, or arthritis of the shoulder; or degeneration, as from aging. The main symptom of rotator cuff disease is shoulder pain of gradual or sudden onset, typically located to the front and side of the shoulder and increasing when the shoulder is moved away from the body. A person with torn rotator cuff tendons may not be able to hold the arm up because of pain. With very severe tears, the arm falls because of weakness; this is called the positive drop sign. Diagnosis is made via observation and can be confirmed with X-rays showing bony injuries; an arthrogram in which contrast dye is injected into the shoulder joint to detect leakage out of the injured rotator cuff; or a magnetic resonance imaging (MRI) scan, which can provide more information than either an X-ray or an arthrogram. Treatment depends on severity. Mild rotator cuff disease is treated with application of ice, rest, and use of anti-inflammatory medications, such as ibuprofen. A patient with persistent pain and motion limitation may benefit from a cortisone injection in the rotator cuff and from doing exercises that are specifically designed to strengthen the rotator cuff. More severe rotator cuff disease may require arthroscopic or open surgical repair. Without treatment, including exercise, the outlook is not very good. Scarring around the shoulder (adhesive capsulitis) can lead to marked limitation of range of shoulder motion, a condition called a frozen shoulder. Some patients never recover full use of the shoulder joint.