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Rotator Cuff Tear

Although there are many reasons for shoulder pain, a common problem for people over 40 years of age is a rotator cuff tear. The rotator cuff is comprised of the muscles and tendons that surround the top of the upper arm bone — the humerus — and hold it in the shoulder joint. A sudden tear may result from a single traumatic event or develop gradually because of repetitive overhead activities. A partial tear may cause pain when the arm is lifted in a certain arc away from the body (painful arc syndrome) and a complete tear may limit the aility to raise the arm. A rotator cuff tear usually occurs in the dominant arm — the right shoulder for right-handed people and the left shoulder for left-handed people.

Signs and symptoms of rotator cuff tears are:

  • Recurrent, constant pain, particularly with overhead activities.
  • Pain at night that prevents you from sleeping on the affected side.
  • Muscle weakness, especially when attempting to lift the arm.
  • Catching and grating or cracking sounds when the arm is moved.
  • Limited motion.

Diagnosis is made through taking a patient's medical history, performing a physical examination and taking X-rays.

In most cases, the initial treatment involves:

  • Rest: If the tear is due in part to overuse, resting the shoulder may help.
  • Nonsteroidal Anti-inflammatory Medications: These medications are used to help control pain.
  • Strengthening and Stretching Exercises: Exercise may be recommended as part of a physical therapy program.
  • Corticosteroid Injections: Corticosteroids can help reduce pain but cannot be repeated frequently because they can weaken the tendon.
  • Ultrasound: Ultrasound can enhance the delivery of drugs applied topically or on the skin and has thermal effects that may help in the healing process.

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Reviewed by health care specialists at UCSF Medical Center.

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