PAINFUL SHOULDER (Shoulder tendonitis, calcific tendonitis, rotator cuff tendonitis, shoulder bursitis, shoulder impingement syndrome)
A painful shoulder may be the result of a single condition. It is not infrequent, however, to have one or more associated conditions occurring at the same time. The rotator cuff is the combination of tendons, muscles, and ligaments that hold the head (ball) of the humerus (upper arm bone) in the shoulder socket (fossa of scapula). The biceps tendon passes over the head of the humerus and is in close association with the rotator cuff. The bursa of the shoulder is also adjacent to these structures.
Athletes and workers commonly complain of pain arising from the muscles, tendons, and ligaments around the shoulder joint. The shoulder joint is the most mobile joint in the body and is frequently subjected to repetitive stress injury in both recreational and occupational activities. Those who frequently reach, lift, or throw overhead are likely candidates to develop one of these conditions. Alternative and frequently use names for this collection of disorders include "pitcher's shoulder", "swimmer's shoulder", "tennis shoulder", and "impingement syndrome".
 Shoulder Tendonitis - Treatment
The pain reduction achieved with ESWT allows a physical or occupational therapist to obtain the best possible results from their treatment. Although ESWT may allow a dramatic improvement in pain, if decreased mobility is present, it cannot be overemphasized that adequate rehabilitation and conditioning is needed in order to regain normal function.
ESWT treatment is often helpful for the painful shoulder. With proper patient selection, 70%-85% of patients may experience good results. Pain relief is often rapid, especially when the pain is identifiable and specific to no more than three well defined areas. Poorly localized pain is unlikely to respond and is usually not treated.
The conventional treatment for painful shoulder may include:- Rest, ice, activity modification
- NSAIDS Non-steroidal anti-inflammatory drugs (e.g.Naprosyn, Advil, Motrin, Nuprin, Alleve, Asprin etc.), Cox inhibitors (Celebrex, etc.)
- Physical therapy (ultrasound, heat, rehab strengthening and stretching exercises)
- Local anesthetic and or steroid injections
- Endoscopic or open surgery
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