Shoulder tendonitis: Causes, Symptoms, Treatment and Cost

Shoulder tendonitis is a condition marked by inflammation of the tendons in the shoulder and surrounding areas.

There are several types of shoulder tendonitis, including:

• Impingement syndrome: Impingement syndrome occurs when the rotator cuff and its tendons become trapped between the top of the upper arm bone (humerus) and part of the shoulder joint (acromion). This can result in pain and reduced range-of-motion.
• Bursitis: Bursitis occurs when inflammation develops in one of several bursae located around the rotator cuff muscles, causing pain when moving at certain angles.
• Tendinopathy: Tendinopathy is a general term that describes any condition related to a tendon's damage or deterioration due to overuse or age, which can result in pain, weakness, and loss-of-motion near or around the affected area.
• Capsulitis: Capsulitis involves inflammation of one or more of the ligaments that attach to and hold together your shoulder joint (capsule). If treatment is delayed for an excessive amount of time, this may result in considerable stiffness, loss of mobility, and even dislocation of the joint.

• Repetitive overhead motions: One of the most common causes of shoulder tendonitis is repetitive use, especially when it involves lifting or reaching overhead. This is especially common in athletes and people who work with their arms raised all day, such as painters or plumbers.
• Poor posture: Poor posture can lead to shoulder tendonitis because it puts strain on the tendons of the shoulders. Sitting at a computer with hunched shoulders or sleeping with your neck in an awkward position can lead to inflammation in the tendons and cause pain and discomfort.
• Injury: An injury to the shoulder, such as a fall or a blow to the area, can cause inflammation of the tendons that may lead to shoulder tendonitis.
• Overuse: Furthermore, inflammation of the tendons in this region may be brought on by excessive usage of the shoulder joint. Too much exercise, lifting heavy objects, or engaging in vigorous activities without rest can all lead to strain on the tendons and cause pain and inflammation over time.

• Pain: The most common symptom of shoulder tendonitis is pain in the affected area, which may be localised or spread to the entire shoulder joint.It is common for the pain to get worse if the affected arm is moved, and it may be accompanied by a burning feeling.
• Reduced Range of Motion: Shoulder tendonitis can cause reduced mobility and flexibility in the shoulder joint, making it difficult or impossible to move the arm through its full range of motion.
• Swelling or Tenderness: Swelling and tenderness around the affected area is another symptom of shoulder tendonitis. When the afflicted region is pressed on or when an effort is made to move the arm through its complete range of motion, this discomfort often becomes more severe.
• Weakness: Weakness in the shoulder joint can also be a symptom of shoulder tendonitis, as inflammation of the tendons can inhibit their ability to contract and relax properly. This weakness may be especially noticeable when attempting to lift objects or perform other activities that require strength and stability from the shoulder joint.

• Maintain Good Posture: Poor posture can cause the shoulder tendons to be overstretched, leading to inflammation and pain.To prevent this from happening, ensure that your posture is correct if you are seated or standing for lengthy periods of time. Make sure your head, shoulders and back are aligned correctly, with your shoulders drawn back in a natural position.
• Avoid Repetitive Arm Movements: Repetitive arm movements such as lifting heavy objects can place strain on the shoulder muscles and tendons, leading to inflammation and pain. If you must lift heavy objects, make sure you use proper form and take frequent breaks to give your shoulders a rest.
• Strengthen Your Shoulder Muscles: Doing exercises that focus on strengthening your shoulder muscles can help reduce inflammation and protect the tendons from further damage. Try doing exercises such as wall push-ups or rotator cuff exercises that target the muscles around the shoulder joint.
• Stretch Regularly: Stretching before and after strenuous activities can help reduce tension in the shoulder muscles and tendons and prevent inflammation from developing in them. Do stretches such as arm circles or shoulder rolls that target the muscles around the shoulder joint for best results.
• Wear Proper Supportive Gear: Wearing supportive gear such as shoulder braces or straps can provide extra support for your shoulders during strenuous activities, reducing strain on the tendons and helping prevent tendonitis from developing.n

• Physical Exam: The doctor will perform a physical examination of the shoulder, which may include a range of motion tests, strength tests, and palpation of the affected area.
• X-Rays: Shoulder discomfort may have a variety of reasons, including arthritis and fractures, both of which can be ruled out with the use of X-rays.
• Ultrasound: Ultrasound imaging can be used to view the soft tissues in the shoulder and can help to diagnose tendonitis or tears in the tendons.
• Magnetic Resonance Imaging (MRI):The tendonitis, rips, or other disorders that might be causing discomfort in the region can be diagnosed with the use of a thorough picture that is provided by an MRI, which is performed on the soft tissues of the shoulder.
• Blood Tests: Blood tests may be used to rule out other causes of shoulder pain such as infection or an autoimmune disorder.

• Reduced range of motion in the shoulder: Tendonitis can cause inflammation of the rotator cuff tendons, impinging on movement and ultimately reducing the range of motion in the shoulder.
• Pain: Inflammation due to tendonitis may cause pain, soreness or stiffness in the shoulder joint, especially with movement.
• Weakness and instability: Long-term tendonitis can lead to weakness and instability in the shoulder joint due to scarring or tearing within the area.
• Adhesive capsulitis: Chronic inflammation from tendonitis can lead to this condition, which causes decreased mobility and potentially permanent damage to cartilage and ligaments around the shoulder joint if left untreated for a long period of time.

• Taking Ashwagandha or Bala root capsules regularly helps reduce inflammation and strengthen the tendons.
• Take 2-3 teaspoons of Castor oil and massage the affected area gently until warm before bathing.
• Applying a paste of ginger and common salt on the affected area several times a day also helps in relieving pain and swelling.
• Apply warm compresses prepared by soaking a towel in lukewarm water to reduce inflammation and soreness in the shoulder joint.
• Practice yoga poses such as Chest Opener, Supine Twist, Puppy Pose, etc., to improve flexibility in the shoulder area.
• Take Cod liver oil or fish oil capsules to enhance joint lubrication and reduce discomfort caused by tendonitis of the shoulder joint

• Eating a balanced, anti-inflammatory diet can help reduce the symptoms of shoulder tendonitis and promote healing.
• Foods rich in antioxidants, such as fruits and vegetables, are especially helpful. Examples include dark leafy greens, berries, bell peppers, and tomatoes.
• Consuming omega-3 fatty acids may also help reduce inflammation and promote healing. Good sources of omega-3s include fatty fish such as salmon, sardines, tuna, and mackerel or plant-based sources such as flaxseeds and walnuts.
• Consuming foods that are rich in calcium may help strengthen bones and lower the likelihood of sustaining an injury to the shoulder.Good sources of calcium include dairy products like milk, yoghurt, and cheese; almonds; sardines; kale; broccoli; fortified cereals; soy milk; tofu; and fortified orange juice.
• Eating foods rich in magnesium may also be beneficial for shoulder tendonitis because it helps support muscle relaxation and reduces inflammation. Good sources of magnesium include dark leafy greens, legumes such as beans or lentils, nuts such as almonds or cashews, whole grains like quinoa or oats, avocados, bananas, salmon, tuna, yoghurt, and dark chocolate.

• Foods high in saturated and trans fats: These can increase inflammation, which can worsen the signs and symptoms of shoulder tendonitis.
• Spicy foods: Eating spicy food may make inflammation and pain in the shoulder worse.
• Processed and fried foods:Since they are heavy in bad fats and additives that might induce inflammation, eating them can make your shoulder tendonitis worse. Inflammation is one of the symptoms of tendonitis.
• High-sodium foods: Too much salt retention can cause swelling, which may exacerbate your shoulder condition.
• Alcohol: Consuming too much alcohol can increase inflammation and slow healing time for a torn or inflamed tendon in your shoulder.

• Physical Therapy: Exercise programs designed by a physical therapist may also be used to help treat shoulder tendonitis along with stretching and massage techniques that can be done at home. The goal of physical therapy is to strengthen and stretch weakened muscles while correcting faulty movement patterns in order to prevent a repeat injury.
• Corticosteroid injection: A doctor may inject a corticosteroid medicine into the shoulder to reduce inflammation, pain, and stiffness.
• Ice/heat therapy: Alternating between ice and heat (or using a combination of both) is often used to reduce pain and swelling in the shoulder area while also promoting healing of any tissue damage caused by tendonitis.
• Arthroscopic Surgery: This type of surgery involves inserting a small camera and surgical instruments into the shoulder joint to repair any tears or damage in the tendons, muscles, and ligaments caused by shoulder tendonitis.
• Subacromial Decompression: This surgery is used to reduce pressure on the rotator cuff tendons and bursa (fluid-filled sacs) in the shoulder joint. It involves removing part of the acromion bone that overlaps the rotator cuff, thus allowing more space for tendon movement.
• Rotator Cuff Repair: This surgery is used when shoulder tendonitis has caused tearing or inflammation in one or more of the rotator cuff tendons. During this procedure, a surgeon will make an incision in your shoulder and suture together any torn tendons to restore them back to their normal function.
• Total Shoulder Replacement: If shoulder tendonitis has caused severe damage to both your rotator cuff and joint cartilage, a total shoulder replacement may be recommended. This procedure involves replacing your damaged joints with metal components to restore movement and reduce pain

• Shoulder tendonitis can be treated by Orthopaedic Doctors, Sports Medicine Specialists, Physical Therapists, and Occupational Therapists.
• An Orthopaedic Doctor is a medical doctor who specialises in assessing and treating musculoskeletal system conditions such as shoulder tendonitis.
• A Sports Medicine Specialist is another type of physician trained to diagnose and treat physical illnesses or injuries related to sports activities and training.
• Physical Therapists utilise physical therapy techniques such as stretching, strengthening, and ultrasound to reduce inflammation and help the patient regain motion in the affected joint or muscle area.
• An Occupational Therapist can assess a patient's injury or condition and provide strategies for the individual to minimise discomfort while performing work-related tasks at home or on the job.

• Non-steroidal anti-inflammatory drugs (NSAIDs): These are medications such as ibuprofen, naproxen sodium, and indomethacin that help reduce inflammation of the shoulder.
• Muscle relaxants: Muscle relaxants such as cyclobenzaprine (Flexeril) or tizanidine (Zanaflex) can help relax the muscles around the shoulder joint and relieve pain.
• Corticosteroids: Injections of corticosteroids like prednisone that are given directly into the shoulder joint may help alleviate the pain and inflammation that are symptoms of shoulder tendonitis.

Recovery time can vary depending on severity and individual healing rates, but with treatment and rest, most people can expect some form of improvement in 2-3 weeks.

Longer-term recovery may take 3-6 months or more with physical therapy, rest, medications, antiinflammatory drugs and other techniques used for treatment.

The results of treatment for shoulder tendonitis vary from person to person.

In the vast majority of instances, non-surgical therapies such as physical therapy, rest, and medication may be used to successfully alleviate symptoms.

However, surgery may be necessary in some cases to fully relieve the pain and restore range of motion in the shoulder joint.

The results of surgery can be permanent if the underlying cause of the tendonitis is corrected.

• Rest: To reduce pain and inflammation, it is important to take a break from activities that aggravate the shoulder joint. This might include avoiding any heavy lifting, reaching, or pushing/pulling activities.
• Ice application: It is important to apply cold packs to the affected area for 10-15 minutes at a time several times throughout the day. The cold will help reduce inflammation and soreness.
• Compression: Wearing an elastic bandage around the joint can help reduce swelling and provide support for the shoulder joint during movement.
• Strengthening exercises: After taking a break from activities that aggravate the shoulder joint, it is important to start doing strengthening exercises for the rotator cuff muscles (which are responsible for stabilising the shoulder). Strengthening these muscles can help reduce pain and improve overall function of the shoulder joint.
• Stretching exercises: It is also important to do stretching exercises for all of the muscles in the shoulder area including those in the chest and back, as well as around the neck and shoulders. Stretching helps enhance flexibility and range of motion in the joint, which may lead to a reduction in joint stiffness and an improvement in the shoulder joint's overall function.
• Posture correction: Maintaining proper posture while sitting, standing, or sleeping can help reduce stress on the shoulder joint which may reduce pain and inflammation associated with tendonitis.
• Physical Therapy: A physical therapist can provide guidance on proper stretching techniques as well as strengthening exercises to help improve overall function of your shoulder joint while reducing pain and inflammation associated with tendonitis

Generally, treatments for mild to moderate tendonitis typically consist of rest, physical therapy, corticosteroid injections, and medications to reduce pain or inflammation.

These treatments can range from around 500 INR to 10,000 INR per visit or course of treatment.

Severe cases may require more intensive interventions such as arthroscopic surgery or manual therapy which can cost up to 1 lakh INR or more.

• Pain relief medications, such as NSAIDs, may cause stomach upset, nausea, or other gastrointestinal problems.
• Physical therapy may cause soreness or discomfort during and after exercises.
• Injections of corticosteroids may produce skin irritation and localised discomfort at the injection site for a short period of time.
• Surgery may be associated with temporary swelling, bruising, numbness or tingling in the affected area, as well as a risk of infection.
• Ultrasound therapy may cause skin irritation due to heat and discomfort during treatment.

Shoulder tendonitis is a frequent ailment that may cause discomfort and impair a person's movement. It is also a painful condition. Shoulder tendonitis may be treated in a variety of ways, the most common of which are rest, physical therapy, anti-inflammatory medicines, and sometimes surgery.