Key Takeaway
Shoulder pain that wakes you at night, causes weakness when lifting the arm, or has persisted for more than a few weeks may indicate a rotator cuff tear. An MRI is needed to confirm the diagnosis, and many tears can be treated without surgery.
The Hallmark Symptoms of a Rotator Cuff Tear
- Night pain — waking up because of shoulder pain, especially when lying on the affected side, is one of the most reliable signs of a rotator cuff problem
- Pain reaching overhead — difficulty or pain when reaching up to a shelf, combing your hair, or reaching behind your back
- Arm weakness — inability to hold a glass of water with an outstretched arm, or difficulty lifting the arm away from the body
- Clicking or popping with shoulder movement — may indicate tendon damage or impingement
- A history of a fall or forced arm movement — acute tears tend to cause more sudden, severe symptoms
Not All Shoulder Pain Is a Rotator Cuff Tear
Several conditions can mimic rotator cuff tear symptoms: shoulder impingement syndrome, calcific tendinitis, shoulder arthritis, AC joint pathology, frozen shoulder, and biceps tendon injury. This is why imaging — particularly MRI — is essential to accurately diagnose the cause of your shoulder pain.
Treatment: Surgery Is Not Always Necessary
- Physical therapy — strengthening the remaining rotator cuff and scapular stabilizers can significantly compensate for a tear and reduce pain
- Corticosteroid injections — a well-placed subacromial injection can reduce inflammation and allow more effective physical therapy participation
- Arthroscopic repair — most commonly recommended for complete tears in younger, active patients; large tears that are progressing; tears that have not responded to conservative care; or acute tears from trauma
Shoulder Pain? Our Specialists Can Help.
We offer same-week shoulder evaluations with on-site MRI at Restore Orthopedics in Orange, CA. Conservative and surgical options available.