Understanding Shoulder Tendonitis

Shoulder pain during everyday movements, like when you lift your arm, reach behind you or even try to sleep, could be a sign of shoulder tendonitis. This common condition affects the rotator cuff tendons and is one of the top reasons people visit an orthopedic specialist.

What Causes Shoulder Tendonitis?

Tendonitis means irritation or inflammation of a tendon. In the shoulder, this usually affects the rotator cuff, a group of muscles and tendons that help stabilize and move the joint.

Common causes of shoulder tendonitis include:

• Repetitive overhead activity (sports, jobs or chores)
• Poor posture or mechanics
• Sudden increases in physical activity
• Age-related tendon wear

“We tend to see shoulder tendonitis in people who stay active, especially if they suddenly ramp up activity or return to exercise after a break,” said Ryan Nixon, MD, an independent orthopedic surgeon who chooses to practice at Franciscan Health. “It’s not always a major injury. It’s often repeated stress, poor mechanics or age-related changes that gradually irritate the tendon.”

“Over time, the tendon starts to break down. It goes through degenerative changes,” he said. Instead of being smooth and strong, it becomes scarred and weak. “You may also develop bursitis, which is inflammation of the fluid-filled sac that cushions the joint.”

Sometimes, the tendon can form bone-like deposits that lead to calcific tendonitis.

“When you have this type of lesion, it’s usually because you had some problem with your shoulder in the past,” Dr. Nixon said. “But when you get this calcium deposit, you have an 80 percent chance of it becoming symptomatic.”

What Are The Signs Of Shoulder Tendonitis?

It’s normal to have occasional shoulder soreness. But if the pain sticks around, it could be tendonitis. Here are the most common symptoms to watch for:

• Pain at night or when you lay on your shoulder
• Pain when you lift or lower your arm
• Shoulder stiffness
• Tenderness or swelling near the top of the shoulder
• Weakness or limited motion

If symptoms continue for weeks or affect your day-to-day life, talk to an orthopedic specialist.

How Is Shoulder Tendonitis Diagnosed?

Diagnosis starts with a physical exam. Your doctor may order an X-ray to check for calcific deposits or arthritis. Magnetic resonance imaging (MRI) shows inflammation and tendon changes.

“With tendonitis, the MRI of the rotator cuff would look streaky or have gray lines going through the tendon,” Dr. Nixon said. “That tendon goes through degenerative changes and turns into scar tissue rather than a healthy tendon. That streaky appearance on an MRI is a sign of degeneration, not tearing.”

Treatment Options For Shoulder Tendonitis

The good news is that shoulder tendonitis often responds well to nonsurgical treatment. In many cases, simple changes and consistent care can reduce pain and restore function. Treatment for shoulder tendonitis may include:

• Anti-inflammatory medication like ibuprofen reduces swelling and eases pain.
• Physical therapy exercises help strengthen the shoulder muscles and improve movement. Therapy can also correct posture and reduce stress on the tendon.
• Changes to your activity level can reduce painful movements.
• Steroid injections reduce inflammation and pain. Dr. Nixon said these aren’t a long-term solution, but they can offer relief during flare-ups.
• Platelet-rich plasma (PRP) injections use your blood to promote healing in the inflamed tendon. “It is effective for any tendon disorder, including tendonitis.”

When To Consider Shoulder Surgery

If symptoms don’t improve after several months of treatment, arthroscopic shoulder surgery might be the next step.

“This procedure helps clean up the tendon, remove calcium or repair the damage,” Dr. Nixon said.

Surgery isn’t always necessary, but when it is, it can significantly restore strength, movement and quality of life. A shoulder specialist can help you understand your options and choose the right path forward.

If shoulder pain interferes with your life, Franciscan Health and our partners are here to help. Explore orthopedic care options to take the first step toward lasting relief.