Shoulder and arm pain: Possible Rotator Cuff Impingement

Patient

Q: I have the symptoms of bursitis, when I went to the Dr he said I am to young to have it and said that the nerves in my shoulder are inflamed. X rays and blood work was taken and they came back fine. I have been on anti inflamitorys for 3 months. Would that prevent something else like another nerve from becoming inflamed? Could the Dr be wrong about the nerves being inflammed and it be bursitis?

Doctor

A:   There are several causes of arm-shoulder pain; one of the most common is the Rotator Cuff tendinitis. The rotator cuff is a group of tendons that support the shoulder. These tendons can be injured during weight lifting, when playing sports with a lot of throwing, after repetitive use over a long time or suffer degenerative changes with the aging process. Typically, the pain worsens at night, a dull ache in the upper outer arm and shoulder, it results from mechanical impingement of the rotator cuff tendon beneath the anteroinferior portion of the acromion (one of the bones of the shoulder joint), causing changes in the distal part of the rotator cuff tendon, which is at risk due to poor blood supply. Conservative treatment of the Rotator Cuff tendonitis involves: physical therapy to control pain and keep range of motion of the shoulder, avoidance of painful movements and activities; anti-inflammatory drugs (i.e.: “Advil”, “Aleve”). If there is poor or no improvement, then, local corticosteroid injection may be considered.

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