SHOULDER TENDONITIS

Treatment for tendonitis, including shoulder or rotator cuff tendonitis, involves a combination of self-care measures, non-surgical treatments, and, in some cases, medical interventions. 

Rest is essential to allow the affected tendon to heal. Avoid activities that aggravate symptoms and give the tendon time to recover. In some cases, immobilization with a sling or brace may be necessary to minimize stress on the tendon.

Ice Therapy, applying ice to the affected area, can help reduce pain and inflammation. Use an ice pack or ice wrapped in a cloth for 15-20 minutes several times daily, especially after activities that exacerbate symptoms.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce pain and inflammation associated with tendonitis. Follow the recommended dosage and use caution if you have any underlying medical conditions.

Physical Therapy play a crucial role in treating tendonitis. A physical therapist can provide exercises to stretch and strengthen the muscles around the shoulder joint, improve flexibility, and correct any biomechanical imbalances that may contribute to tendonitis. Modalities such as ultrasound, electrical stimulation, or manual therapy techniques may also be used to reduce pain and promote healing.

Activity Modification: Modify activities or sports that exacerbate symptoms of tendonitis. Avoid repetitive overhead movements, heavy lifting, or activities that stress the affected tendon excessively. Gradually reintroduce activities as symptoms improve and with guidance from our medical team.

Corticosteroid Injections: In cases of severe pain or inflammation that do not respond to conservative treatments, Dr. Pournaras may recommend a corticosteroid injections into the affected tendon or the surrounding area. Corticosteroids can help reduce inflammation and provide temporary pain relief, but they should be used judiciously due to potential side effects.

Platelet-Rich Plasma (PRP) Therapy: PRP therapy involves injecting concentrated platelets from the patient’s own blood into the affected tendon to promote healing. PRP therapy may be considered for chronic or refractory cases of tendonitis, although evidence for its effectiveness is mixed.

Extracorporeal Shockwave Therapy (ESWT): ESWT is a non-invasive procedure that uses shockwave energy to stimulate healing in the affected tendon. ESWT may be considered for chronic tendonitis that has not responded to other treatments.

Surgery: In rare cases of severe or chronic tendonitis that do not respond to conservative treatments, surgery may be necessary. Surgical options may include tendon debridement (removal of damaged tissue), tendon repair, or in some cases, tendon transfer or reconstruction.

It’s important to consult our medical team for an accurate diagnosis and appropriate treatment plan for tendonitis. Early intervention and proper management can help reduce pain, improve function, and promote healing of the affected tendon.

Surgical options for shoulder tendonitis, particularly rotator cuff tendonitis, are considered when non-surgical treatments have failed to address the condition adequately or in cases of severe tendon damage or chronic degeneration.

Surgery can repair the damaged tendon, alleviate pain, and restore function to the shoulder.

Rotator Cuff Repair: Rotator cuff repair is a surgical procedure to repair torn or damaged tendons in the rotator cuff. During this procedure, Dr. Pournaras will reattach the torn tendon to the bone using sutures or anchors. Depending on the size and location of the tear, rotator cuff repair can be performed using arthroscopic or open surgical techniques.

Subacromial Decompression: Subacromial decompression is a surgical procedure used to relieve pressure on the rotator cuff tendons and the subacromial bursa (a fluid-filled sac) beneath the acromion (a bony projection of the shoulder blade). During this procedure, Dr. Pournaras will remove a small portion of the acromion or the bursa to create more space for the rotator cuff tendons, reducing the risk of impingement and inflammation.

Acromioplasty is a type of subacromial decompression procedure that involves shaving down or removing a portion of the acromion to alleviate pressure on the rotator cuff tendons. This procedure may be combined with rotator cuff repair or performed as a standalone procedure for impingement syndrome.

Biceps Tenodesis is a surgical procedure used to address the long head of the biceps tendon pathology, which can contribute to shoulder tendonitis. During this procedure, Dr. Pournaras will detach the biceps tendon from its original attachment in the shoulder joint and reattach it to a different location on the humerus (upper arm bone). This helps to alleviate pain and prevent further tendon damage.

Tendon Transfer: In cases of severe rotator cuff tendonitis or irreparable tendon tears, tendon transfer procedures may be considered. Tendon transfer involves transferring a healthy tendon from another part of the body to replace the damaged or deficient rotator cuff tendon. This can help restore shoulder function and stability.

Debridement: In some cases of chronic tendonitis with degenerative changes, surgical debridement may be performed to remove damaged or diseased tissue from the affected tendon. Debridement procedures aim to alleviate pain and improve tendon healing.

PRP Injection: Platelet-rich plasma (PRP) injection may be used as an adjunct to surgical treatment for shoulder tendonitis. PRP therapy involves injecting concentrated platelets from the patient’s own blood into the affected tendon to promote healing and tissue regeneration.

The choice of surgical procedure will depend on various factors, including the underlying cause of tendonitis, the extent of tendon damage, and the patient’s overall health and functional goals. It’s important to discuss the risks, benefits, and potential outcomes of surgery with Dr. Pournaras to determine the most appropriate treatment approach for shoulder tendonitis.