Clinical Management and Manifestation of Rotator Cuff Tendinitis

Background: Shoulder pain is one of the leading causes of musculoskeletal disorders after low back pain and cervical pain, and rotator cuff tendinitis contributes to most common cause of the shoulder pain in person aged 70 years or older. Overuse injuries from repetitive lifting, pushing, pulling and throwing and traumatic tear in tendons from a fall or accidents are other major contributing factors to shoulder pain due to rotator cuff tendinitis. Objective: The study was designed to describe the different pain presenting patterns and symptoms accompanying rotator cuff tendinitis along with different treatment methods and their outcomes in managing rotator cuff tendinitis. Methodology: A descriptive case series study design, describing the pain presenting patterns and symptoms accompanying the rotator cuff tendinitis and outcome of different treatment method given to them. 25 patients with the age range of 21-71 years were selected using non-probability sampling from the outpatient department of physical therapy and orthopedic surgery of Fatimah Memorial Hospital, Lahore. A self administered questionnaire and standardized physical examination were used to record the demographic and objective findings. Each case was managed with Mulligan concept of Mobilization with movement (MWM) and improvement in pain was recorded on VAS before and after treatment session. Results: 25 patients were selected with the mean age of 42.7 ± 14.8 years with more males (14) and less females (11). Mean duration of pain was 8.9 ± 11.4 weeks with 72% patients having duration of sickness between 1-8 weeks. 76% patients had pain of constant nature as compared to 24% which had a pain of intermittent type. When measured on VAS, 44% patients had severe pain (7-10) in comparison to 56% patients which rated their pain as moderate (3-6). In describing the location of shoulder pain majority of the patients (72%) had pain on the antero-superior aspect of the shoulder, 4% had antero-lateral pain while 1% had posterior pain. Empty can test was maximum positive up to 76% in all patients, Hawkins Kennedy up to 29%, Neer test 13% and Drop Arm test in 3%. Patients treated with manual therapy along with medications showed 100% recovery while patients treated with manual therapy and mechanical therapy showed 75% recovery. Conclusion: According to the results of this study, rotator cuff tendinitis affects male more than females, but this more related to the kind of activity performed by the patients than to sex. It more common in right shoulder, antero-superior aspect in particularly. Most of the patients had acute onset of disease. Manual therapy technique of MWM proved to be effective treatment option in improving pain in management of rotator cuff tendinitis.