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Common sources of shoulder pain – the Rotator Cuff

By David Ryan, MD | May 2, 2015

May 2

There are many reasons for patients to come see an orthopedic surgeon, but one of the most recognized and successfully treated problems we see are rotator cuff tears.  The rotator cuff is a series of four deep muscles in the shoulder, which functions to keep the ball and socket shoulder joint centered for optimal range of motion. The rotator cuff is prone to deterioration through aging and therefore a significant number of people have noticed pain from either a partial or complete tear of one or more muscles of the rotator cuff.  This can be through significant trauma or more likely a minor trauma imparted on a degenerated muscle.

What symptoms will I have?

Typical shoulder pain from rotator cuff pathology is centered over the deltoid muscle of the upper arm and can radiate close to the elbow, but typically not past the elbow.  There can be associated weakness as well but most of the pain is noticed during activities in which one’s arm is over his or her head.

What treatments are available?

The treatment regimen for rotator cuff problems is highly variable and is a topic that is still debated among orthopedic surgeons, so there is no single “best” way that is universally agreed upon.  For this reason, I feel it is helpful for patients to know what their options for care are, so a personalized treatment plan can be formulated that conforms to individual needs.  Fortunately, most rotator cuff pain can be made better through non-operative measures such as physical therapy and potentially corticosteroid (cortisone) injections which can be provided during a typical office visit.

Is surgery ever required?

Surgical repair of a rotator cuff is sometimes warranted when non-operative measures are not satisfactory.  Although older techniques are still used, orthopedic surgeons practicing today will usually perform these surgeries arthroscopically, which is a minimally invasive surgical technique employing small cameras and tools with the biggest incision being no bigger than the width of a finger.  Being a fellowship trained arthroscopic surgeon, I have had the opportunity to be on the cutting edge of arthroscopic surgery and am excited to be able to offer these techniques to my patients.  I have been very pleased with the results achieved in patients following a rotator cuff repair as it can truly be a life altering surgery for patients with this type of shoulder pain.

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