Q. I have had pain in my right shoulder for the last four months. I do not recall injuring it, but the pain has worsened. It is not as bad during the day unless I lift something heavy overhead, but the pain is really bad at night and wakes me. I have tried taking Advil and not using my arm as much, but that hasn’t helped. I went to my primary care doctor who did X-rays, which showed that nothing was broken. He said it would likely go away. What should I do?
A: It would be helpful to know your age as injuries to the rotator cuff tendon are more common as we get older. There are four muscles from the front, top and back of the shoulder that attach to the ball part of the shoulder that allows it to rotate. This is known as the rotator cuff tendon.
Young athletes — such as quarterbacks and pitchers — usually require significant trauma to tear the rotator cuff tendon. As people age, many times the rotator cuff tendon can just tear from years of use and in some patients this could result in pain or weakness of the shoulder. Night pain is a classic symptom of rotator cuff tears and I recommend you see an orthopedic surgeon for evaluation. Since X-rays only show the bone, they are not always helpful in diagnosing rotator cuff injuries. You likely will require an MRI scan, which will show the rotator cuff tendon, labral cartilage, and any significant arthritic changes present.
If the tendon is just inflamed “tendonitis,” this will likely get better with a period of anti-inflammatories and physical therapy. If a significant tear of the rotator cuff tendon is noted particularly since this is your dominant shoulder, you likely will require arthroscopic surgery to repair the rotator cuff tendon tear.
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Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net