Rotator cuff syndrome also known as rotator cuff injuries consist of three major types. These types include rotator cuff tendonitis, rotator cuff impingement syndrome and rotator cuff tear (Bunker, 2002). The etiology of rotator cuff tendonitis is the inflammation and irritation of the rotator cuff muscles. Entrapping of the rotator cuff tendon in the sub-acromial space causes rotator cuff impingement syndrome.  Rotator cuff tear is caused by the tear of the tendon of rotator cuff rather than muscles themselves (Murrell & Walton, 2001). Both the rotator cuff syndrome and rotator cuff tear have some similar diagnosis (Bunker, 2002).The major symptoms in both are pain and weakness of the shoulder joint. In both, the doctor starts by taking the history of the patient and physical examination of the shoulder joint. Both can also be diagnosed by taking an x-ray of the shoulder or even carrying out more specialized investigations such as Ultrasound or even MRI.

The diagnoses of both conditions still have some differences. In rotator cuff tear, the doctor may refer a patient to a specialist. This referral is done if the doctor suspects a full tear of the tendon of rotator cuff (Murrell & Walton, 2001).Orthopedicsurgeons or bone and joint specialists provide more specialized care to these patients. Rotator cuff tear is also diagnosed by drop arm test. In this test, the patient can lower his arm slowly up to 90% but when he try to lower it below 90% the arm drop suddenly on his side because of the tear. Rotator cuff syndrome also has other specific diagnoses. Pain arc test is used to diagnose rotator cuff syndrome such as rotator cuff tendonitis. The doctor requests the patient to lift his arm outward from his side in any arc in this test. Pain is felt between 70 to 120% in this arc (Bunker, 2002). Neer’s impingement test is used to diagnose rotator cuff impingement syndrome. The doctor asks the patient to straighten his arm in this test. Then raise his arm backward, keeping his palm pointing away from the body. Pain demonstrates that the test is positive.

Both conditions have almost the same methods of treatment. The first treatment method is the use of painkillers. Painkillers such as paracetamol are very useful in both conditions. Use of stronger pain killers is also recommended if the injury is severe. Regular Anti-inflammatories are also useful in their treatment. These are painkillers with added anti-inflammatory properties. They include naproxen, diclofenac, and ibuprofen. These drugs are associated with some side effects (Bunker, 2002). Patients should be cautious while taking these medications to avoid the extreme effects of side effects. The use of ice packs is also effective in pain reduction. Physiotherapy is useful in minor rotator cuff injuries. Shoulder exercises together with physiotherapist advice are significant in minor injury healing (Murrell & Walton, 2001). Some doctors prescribe steroid injection around the shoulder joint as means of reducing inflammation in minor rotator cuff injuries. Doctors suggest the use of surgery for the treatment of complicated rotator cuff injuries (Murrell & Walton, 2001). The surgery involves widening or decompression of the space below the acromion and may also involve the repair of the rotator cuff tendon and muscles. This type of surgery is mainly done through open or keyhole method. Early diagnoses and treatment of the rotator cuff injuries yield good prognosis.

References

Bunker, T. (2002). Rotator cuff disease. Current Orthopaedics, 16(3), 223-233.

Murrell, G. A., & Walton, J. R. (2001). Diagnosis of rotator cuff tears. The Lancet, 357(9258), 769-770.