Rotator Cuff Tendonitis Treatment: What to Expect

Shoulder pain can be more than just a nuisance – it can interfere with your sleep, your workouts, and even something as simple as reaching for a coffee mug. If this sounds familiar, you might be dealing with rotator cuff tendonitis. However, rotator cuff tendonitis treatment options can range from non-invasive to surgical, and early diagnosis can improve your outcomes.

Shoulder pain can disrupt your daily life. Make an appointment with an orthopedic specialist to discuss your treatment options and start the process.

What is rotator cuff tendonitis?

Rotator cuff tendonitis (also called rotator cuff tendinopathy or shoulder impingement syndrome) is inflammation or irritation of the tendons in your shoulder’s rotator cuff. This group of muscles and tendons helps stabilize your shoulder and allows you to lift and rotate your arm.

When these tendons become inflamed – often due to repetitive overhead movements, poor posture or age-related wear and tear – you may experience:

• A dull ache deep in the shoulder
• Pain that worsens with overhead activity
• Difficulty sleeping on the affected side
• Weakness or limited range of motion

Because of repetitive, over-the-head motions, swimmers, baseball players, softball players, tennis players and other athletes are at higher risk of developing this type of shoulder pain, says Michael Laidlaw, MD, an orthopedic surgeon in our Cincinnati market.

How it’s diagnosed

The most common symptom of rotator cuff tendonitis is pain in the outer part of the upper arm or on the top of the shoulder. You might also notice a “clicking” sound, loss of range of motion and tenderness in the shoulder joint. The shoulder pain typically worsens over time and could become so severe that it wakes you up at night.

Diagnosis typically begins with a physical exam. Your provider may:

• Press on different parts of your shoulder
• Move your arm into various positions
• Test your strength and range of motion

To confirm the diagnosis or rule out other issues, imaging tests may be used:

• X-rays: To check for bone spurs or arthritis
• Ultrasound: To view soft tissues in motion
• MRI: To get detailed images of tendons and muscles

Rotator cuff tendonitis treatment options

Some minor cases of rotator cuff tendonitis can be treated successfully without medical intervention, although you should always consult with an orthopedic specialist. With mild to moderate symptoms, less severe cases of tendonitis may be treatable with stretching and anti-inflammatory medications.

Make an appointment with a specialist as soon as you feel the pain. You should also take a break from the activities that have caused the pain. Ice the affected area and then use heat therapy when the pain starts to subside.

Conservative (non-invasive) treatments include:

• Rest and ice: Avoid activities that aggravate your shoulder. Applying ice for 15 to 20 minutes a few times a day can help reduce inflammation.
• Physical therapy: This is often the first and most effective treatment. A physical therapist will guide you through exercises to improve flexibility, strengthen the rotator cuff and surrounding muscles and restore full range of motion.
• Medications: Over-the-counter NSAIDs like ibuprofen or naproxen can help manage pain and inflammation.
• Corticosteroid injections: If pain is severe or interfering with daily life, a steroid injection into the shoulder joint may provide temporary relief. However, repeated injections can weaken tendons over time, so they’re used sparingly.

“Working with a physical therapist can help strengthen your shoulder and restore mobility before returning to activities,” Dr. Laidlaw says.

However, surgery is considered when symptoms persist after several months of conservative treatment or if there’s a significant tear.

• Arthroscopic tendon repair: A minimally invasive procedure using a small camera and instruments to reattach the tendon.
• Open tendon repair: Used for more complex injuries, this involves a larger incision to access and repair the tendon.
• Tendon transfer: If the tendon is too damaged to repair, a nearby tendon may be used as a substitute.
• Reverse shoulder replacement: For massive, irreparable tears, this procedure swaps the ball and socket of the shoulder joint to improve stability and function.

What to expect during recovery

Recovery time varies depending on the severity of the condition and the treatment used. With physical therapy alone, many people see improvement within a few weeks to months. Post-surgical recovery may take several months and includes a structured rehab program.

The key to long-term success involves sticking with your rehab plan and avoiding activities that strain your shoulder until you’re fully healed.

“After surgery, a personalized recovery treatment plan with your doctor and physical therapist will help to get you back in action,” Dr. Laidlaw adds.

When to see an orthopedic specialist

If you have moderate to severe symptoms, symptoms that are not improving or are affecting your daily activities, make an appointment with your doctor immediately. Rotator cuff tendonitis is curable and most people recover with appropriate treatment, which can range from physical therapy to surgery.

It’s time to make an appointment with an orthopedic specialist if your shoulder pain:

• Persists for more than a few weeks
• Worsens despite rest and home care
• Interferes with sleep or daily activities

Early diagnosis and treatment can prevent further damage and speed up your recovery.

Can you prevent rotator cuff tendonitis?

To stay healthy and prevent future cases of rotator cuff tendonitis, avoid carrying heavy objects or bags on one shoulder and try not to sleep on the same side every night. Rest from any sports that caused the condition and avoid repeatedly lifting your arms overhead.

How we can help

Early diagnosis and treatment for rotator cuff tendonitis can help you return to your activities quickly. If you think you have rotator cuff tendonitis, make an appointment with an orthopedic specialist. Athletes can schedule with a sports medicine doctor.

Learn about the orthopedic and sports medicine services we offer at Mercy Health.