Shoulder pain is common in middle-aged people, often due to overuse injuries to the rotator cuff tendons, especially the supraspinatus tendon, and the bursa. The shoulder joint is very mobile but not very stable. The rotator cuff muscles and tendons (supraspinatus, infraspinatus, teres minor, and subscapularis) help stabilise it.
Tendons can become painful (tendinopathy) from sudden activity changes, repetitive use, and pressure. This is more likely as you age because tendons become less elastic and more prone to tearing. The supraspinatus tendon, located above the humeral head and below the bursa, is a common source of pain.
Causes
Causes of supraspinatus tendinopathy/bursitis include poor posture during overhead movements, direct trauma, a hooked acromion, or arthritis. Muscle imbalances, age-related tendon tears, poor posture, and weak scapular muscles also contribute to tendinopathy.
Signs and Symptoms
Pain increases with reaching and repetitive activities at or above shoulder height
Weakness with pushing and overhead movements
Difficulty sleeping due to pain, especially when lying on the painful shoulder
Trouble with simple tasks like brushing hair, putting on a shirt or jacket, or reaching above shoulder height
Limited shoulder range of motion
History of shoulder trauma
These symptoms are enough for diagnosis. An ultrasound or MRI isn't needed in the acute phase, as they often show age-related changes in the tendons regardless of pain.
Management
When dealing with shoulder pain from supraspinatus tendinopathy and bursitis, conservative management is usually the best approach. Start with some rest and avoid activities that make the pain worse. Taking simple painkillers can help in the early stages.
Once the pain is under control, a gradual strengthening exercise program for the rotator cuff and scapula muscles, along with improving your posture, is recommended. Your physiotherapist can create a personalised exercise plan to address the specific causes of your shoulder pain.
Surgery is rarely needed and is only considered if conservative treatments fail and a shoulder surgeon recommends it.
