Rotator Cuff Tendinopathy

The rotator cuff is composed of subscapularis, supraspinatus, infraspinatus, and teres minor muscles and serves as stabilizer of the shoulder joint. Rotator cuff disease, one of the common causes of shoulder pain, encompasses a spectrum of pathologies, including subacromial or subdeltoid bursal pathology, rotator cuff tendinopathy, and partial- and full-thickness rotator cuff tears. Rotator cuff tendinopathy is characterized by inflammation and fibrosis that derive from mechanical impingement and biologic degeneration. Supraspinatus is the most commonly affected tendon. The diagnosis of rotator cuff tendinopathy is mainly made by history and physical examinations. Shoulder pain, loss of range of motion, and limitation in overhead activities are the most common complaints. Numerous special tests are available to evaluate impingement and each rotator cuff tendon. Magnetic resonance imaging can reveal abnormal T2 signal within the substance of the rotator cuff tendon, although it is usually unnecessary for making diagnosis. Nonoperative treatment is the mainstay of treatment for rotator cuff tendinopathy, which entails pharmacologic treatment, physical therapy, and interventional procedures. Pain control can be achieved by nonsteroidal anti-inflammatory drugs, selective cyclooxygenase-2 inhibitor, acetaminophen, and cryotherapy. Physical therapy aims at range of motion, strengthening, and proprioception.