Miscellaneous
causes of upper extremity pain
Miscellaneous causes:
Rotator cuff tendinitis
The rotator cuff is a set of four muscles (Supraspinatus,
Infraspinatus, Subscapularis, and Teres Minor) that
lie over the humeral head in the shoulder that help
provide shoulder stability. These muscles can become
inflamed and produce shoulder pain. The pain tends to
be:
-
Generally worse at night or after activity
-
Shoulder motion causes pain and is limited
-
More common in athletes who do a lot of throwing
-
More common in older individuals (over 50)
If the pain is severe, it can be difficult to distinguish
between rotator cuff tendinitis and a cervical radiculopathy.
In such cases, an injection of a numbing agent (such
as Lidocaine) into the shoulder area can help. If the
pain is completely relieved, then the cuff is probably
the pain generator (not the nerve).
Tendinitis may be associated with a rotator cuff tear,
which can be diagnosed with either an MRI scan or an
arthrogram of the shoulder.
NSAID's medications and exercise
Treatment includes NSAID’s and physical therapy
exercises to strengthen the rotator cuff. For more severe cases,
a steroid injection into the shoulder can help decrease
the inflammation. If a tear is present, surgery may
be necessary to repair the torn muscle/tendon.
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