Because the supraspinatus muscle allows the shoulder to move the arm away from the body, supraspinatus tendonitis is usually characterized by the pain and weakness on the tip of the shoulder when the arm is moved sideways or upward above the head. The onset of the condition is gradual. The front and upper part of the shoulder may also become swollen and tender. In severe cases, you cannot even lift you arm to shoulder height.Causes
The pain is caused by irritation and inflammation of the supraspinatus rubbing under the acromion process, or outside tip of the shoulder blade, when you raise your arm. The pain is brought on by:
- Repetitive overarm motions
- Sudden increase in the frequency, intensity or duration of physical activity
Risk Factors
- A congenital “spur” shaped acromion (type III)
- Shoulder instability
- Repetitive use of arms above head, or elbows away from the body
- Previous history of tendonitis
Treatment
Immediate Action
- Ice the shoulder three times a day for 20-30 minutes.
- Maintain activities, modifying movements to avoid pain.
- Take anti-inflammatories as directed.
- If pain persists, stop the activity.
- Implement a conditioning program to stretch and strengthen rotator cuff muscles.
See Your Doctor If:.
If symptoms persist for more than two weeks.Procedures
Cortisone injections: These will take about 48 hours to relieve the tendonitis symptoms. You should not perform any activities that could aggravate your shoulder for two weeks. It usually takes cortisone three weeks to clear up tendonitis.
Surgery: If cortisone and rest do not relieve your tendonitis, arthroscopic surgery may be necessary to make more room for the tendon in your shoulder. To do this, your surgeon will remove the coracoacromial ligament, trim off calcifications of the acromion and excise the nearby bursa. If your tendons are significantly torn, the surgeon will stitch them together. Recovery
If diagnosed early, supraspinatus tendonitis can be cleared up in 1-3 weeks by modifying your activities and performing rehabilitation exercises. Recovery could take as much as six weeks if your tendonitis is moderately severe. Recovery from surgery takes between six and twelve weeks of rest and rehab before returning to physical activities (sports).Medications
To relieve minor to moderate pain, take acetaminophen, as directed on label. To relieve pain and inflammation, take ibuprofen or aspirin, if tolerated.Prevention- An aggressive rotator cuff strengthening and stretching program
- Avoidance of repetitive use of arms above head or elbows away from the body
- Acute intervention with RICE (rest, ice Compression, elevation) before symptoms progress
Resources
Johns Hopkins Bayview Medical Center
Dr. Lamb.com
Emedicine
Last updated: 26-Nov-01
