Shoulder Tendonitis

Shoulder tendonitis is a condition due to inflammation of the tendons and is one of the most common causes of shoulder pain.

The tendons play a dominant role in the execution of the movement of the upper limb, since, thanks to them, the muscles touch the bones and thus, the hand acquires the ability to move in space.

Shoulder tendonitis is characterized by acute pain as its primary symptom and limits significantly, the movement of the shoulder.

The most important tendons in the shoulder are four: the supraspinatus, the infraspinatus, the teres minor and the subscapularis muscles. All of these create a group of tendons, which is called the rotator horseshoe. Another tendon that is vulnerable to stress, is the biceps tendon.

These tendons are responsible for all shoulder movements and when their disturbance exceeds a certain level, inflammation is created. Some factors that contribute to its appearance are:

1. Intense muscle activity: When the muscles are constantly working to perform a movement, the corresponding tendon is also strained, and thus, the chances of tendon irritation are greater.
2. Long strain duration: The incessant strain on the shoulder muscles is intertwined with the increasing accumulation of load on the rotator horseshoe of the shoulder, resulting in the development of tendonitis.
3. Shoulder anatomy: If one of the two bone structures (the acromium), around which the shoulder tendons move, protrudes a lot, then it is easier to develop tendonitis due to the friction of the tendon on the lower surface of the acromium.

The main and often, the only symptom of shoulder tendonitis is pain, the intensity of which of course varies, depending on the severity of the strain.

It is usually located on the outer side of the shoulder and arm, but it can also reflect on the neck. It can be either, permanent or occasional and can vary depending on movements.

The patient with tendonitis has difficulty moving his shoulder and finding a comfortable resting position, especially when sleeping, where it is almost impossible to lie down on the affected area.

The diagnosis of shoulder tendonitis is made by a combination of history, clinical examination and imaging examination. Shoulder ultrasound and MRI are the two necessary diagnostic tests, which will reveal the extent of tendon damage.

Conservative

In the initial stages, rest and administration of anti-inflammatory and analgesic treatment for a short period of time is recommended.

In acute tendonitis and, as soon as, the days of intense pain have passed, the patient is necessary to join a physiotherapy program to improve symptoms and maintain movement. In the case of chronic tendonitis, physiotherapy to restore movement can be started immediately.

Surgical treatment

In chronic tendonitis  due to shoulder impact syndrome, arthroscopic treatment offers a definitive solution to the problem. During  shoulder arthroscopy,  the tendon is cleaned through two small holes and the excess bone that creates pressure on the tendon is removed with special tools. Anesthesia is usually, total and recovery is very short. Hospitalization lasts only a few hours. The patient’s return to normal activities takes place within 4 weeks.