Rotator cuff tear symptoms

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Symptoms from rotator cuff tear vary depending on whether the tear is acute or chronic.

Acute tears tend to occur with an injury. The weekend warrior who tries to blast a tennis serve without stretching or warming up is an example. Sharp stabbing pain followed by a dull throbbing is noted. The pain is felt at the top of the shoulder and sometimes to the side as well. Also, a patient will find weakness in the arm. They’ll have difficulty raising the arm without pain. If the tear is exceptionally large, the patient will not be able to raise the arm at all. Swelling may be present.

Chronic rotator cuff tears behave differently. Patients with chronic tears will have dull aching pain that sharpens and intensifies with movement. They will also have pain at rest. Night pain is common.

As with acute tears, if the chronic tear is large, the patient will have weakness in the shoulder and will have difficulty raising the arm.

The cause of rotator cuff tears varies also. Younger patients have tears because of repetitive motion and shearing forces. Examples would be pitchers and swimmers.

Older patients develop tears because of a low grade continuous wear and tear. Arthritis develops in the shoulder and arthritic spurs rubbing against the rotator cuff cause the tendons tend to become worn and frayed.

On exam, the classic physical finding is the "drop sign." If the patient's arm is abducted to 90 degrees and the physician lets go, the patient will be unable to keep the arm up.

A newer treatment for tendonitis may be effective and prevent the need for surgery. Percutaneous needle tenotomy is a technique where a small gauge needle is introduced using local anesthetic and ultrasound guidance. The needle is used to poke several small holes in the fascia. This procedure is called "tenotomy." Tenotomy induces an acute inflammatory response. Then, platelet rich plasma, obtained from a sample of the patient's whole blood is injected into the area where tenotomy has been performed. Platelets are cells that contain multiple healing and growth factors. The result? Normal good quality fascial tissue is stimulated to grow with natural healing.

For more information about this procedure, visit our sister site:
Tendonitis provides reliable, accurate, and useful information on tendonitis treatment written by a board-certified rheumatologist. Learn more about how to get tendonitis relief using the most up-to-date methods.

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