Common causes
- Rotator cuff tendon irritation or tearing from overload, trauma or age-related change.
- Subacromial bursitis or irritation of tissues around the tendons.
- Frozen shoulder with progressive stiffness of the joint capsule.
- Shoulder instability or labral injury following trauma.
- Pain referred from the neck or a pinched nerve.
How we evaluate
History addresses the onset of pain, injury, night symptoms, weakness and the work or sport demands placed on the shoulder. A hands-on osteopathic and physiatric examination tests motion, strength and specific tendon and joint signs, and screens the neck for contributing problems. Prior imaging is reviewed, and diagnostic ultrasound can visualize the rotator cuff and bursa dynamically while guiding selected procedures. Suspected full-thickness tears, significant trauma or progressive weakness may call for imaging or surgical consultation before rehabilitation is finalized.
Treatment options
we may discuss.
Performance Health / rehabilitation
Rehabilitation may address rotator cuff and shoulder-blade strength, comfortable mobility and a graded return to lifting, reaching and sport. Many partial-thickness tendon problems and bursitis respond to structured loading programs. Most shoulder pain can be managed without surgery; a surgical opinion is sought only for significant tears, instability or persistent limitation that truly warrants it.
Regenerative & Cell-Based Medicine
When appropriate, PRP may be discussed for selected rotator cuff tendon problems, with evidence that varies by tear type and severity. Prolotherapy may be considered for selected ligament-related contributors. Cell-based and biologic options require a separate review of evidence, risks and applicable law. Regenerative care is paired with rehabilitation, not substituted for it.
Targeted Pain Management
Medication review and precise, ultrasound-guided procedures may address an identified pain source. When it's needed, a steroid injection can calm a clearly inflamed bursa or joint, with attention to the number and timing of injections near tendons. Image-guided hydrodistension may be discussed for selected frozen shoulder. Procedures are image-guided, using ultrasound or X-ray guidance depending on the target.
Related treatments
From the Journal
Related conditions
Common
questions.
When to seek
care urgently.
Seek urgent medical care for a hot, swollen shoulder with fever, sudden deformity after injury, or new arm weakness with numbness or a cold hand.
This page is general information, not medical advice. Individual results vary. Medical Disclaimer